Reimbursement Specialist – Outpatient Medication Authorization

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

📋 Description

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

• Assess department-specific reports and offer constructive feedback.

• Ensure that charge items are accurate and compliant, resolving any billing discrepancies utilizing clinical and coding expertise.

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

• Provide historical data to aid management in forecasting.

• Collaborate with departmental directors, managers, and staff to maintain budgetary adherence.

• Manage accounts receivable and/or financial reporting systems.

• Prepare reports and analyses for PRMO, DUHS, and PDC leadership teams.

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

• Analyze and report on departmental performance indicators and objectives.

• Suggest enhancements to financial systems and execute in-house operating unit audits.

• Assist in developing departmental goals and objectives.

• Manage and delegate database inquiries when necessary.

• Create work assignments and provide training for employees.

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

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

• Conduct quality reviews of employees and give feedback to management and staff when appropriate.

• Develop and deliver job-specific training programs.

• Perform additional related duties as required.

⛳️ Requirements

• A high school diploma or equivalent is required.

• Post-secondary coursework in Accounting, Finance, Economics, Business Administration, or a related discipline is preferred.

• A minimum of four years of relevant experience in healthcare is required.

• A Bachelor's degree in a related area can be accepted in lieu of the required experience.

• Proficiency in clinical and coding knowledge.

• Familiarity with revenue cycle, charging, billing, accounts receivable, and/or financial reporting systems.

• Capability to analyze departmental reports and performance metrics.

• Ability to coordinate projects and conduct audits.

• Competence in preparing written reports and analyses.

• Proficient in communication with insurance companies, governmental entities, providers, and support staff.

• Degrees, Licensures, Certifications: N/A

🏝️ Benefits

• Opportunity to work remotely.

• Monday to Friday first shift schedule.

• Equal Opportunity Employer.

• Information and provisions for reasonable accommodations are available.