Reimbursement Specialist – Outpatient Medication Authorization

This is a fully remote position, open to applicants in North Carolina.

📋 Description

• Compile, analyze, and report on the performance of departmental operating units.

• Evaluate departmental reports and offer constructive feedback.

• Ensure the accuracy and compliance of charge items while addressing billing discrepancies.

• Oversee projects and audits aimed at enhancing revenue-cycle, charging, billing, and collection processes.

• Support management in forecasting by utilizing historical data.

• Collaborate with directors, managers, and pertinent personnel to guarantee budget adherence.

• Administer accounts receivable and/or financial reporting systems, preparing reports and analyses for PRMO, DUHS, and PDC leadership.

• Facilitate communication between insurance companies, governmental agencies, providers, and support staff.

• Monitor and report on departmental performance indicators and objectives.

• Suggest enhancements to financial systems and perform audits of operating units.

• Assist in the development of departmental goals and objectives.

• Manage and delegate database inquiries as necessary.

• Create work assignments and provide training for employees.

• Foster relationships with both internal and external agencies and professional organizations.

• Act as a liaison between physicians and the PRMO when required.

• Conduct employee quality assessments and deliver feedback to both management and staff.

• Develop and provide training tailored to specific job roles.

• Execute other related duties as assigned.

⛳️ Requirements

• High school diploma or equivalent is mandatory.

• Preference for post-secondary coursework in Accounting, Finance, Economics, Business Administration, or a related discipline.

• Minimum of four years of relevant experience in the healthcare sector is required.

• A Bachelor's degree in a related field may substitute for the experience requirement.

• Familiarity with clinical and coding practices.

• Understanding of accounts receivable and/or financial reporting systems.

• Capability to analyze departmental reports and performance metrics.

• Proficiency in coordinating projects and audits.

• Strong communication skills with insurance companies, governmental agencies, providers, and support staff.

🏝️ Benefits

• Option for remote work.

• First-shift schedule, Monday through Friday.

• Commitment to equal employment opportunities.

• Support for reasonable accommodations.