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Reimbursement Specialist

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Arcadia Home Care and Staffing - an Addus family company

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Location:
United States , Frisco

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Category:
Finance

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Contract Type:
Not provided

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Salary:

Not provided
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Job Description:

The Reimbursement Specialist (Skilled Reimbursement/Hospice) will be responsible for billing and revenue cycle management thorough insurance benefit investigation of new referrals, assignment of collections with a variety of payers, authorization requests, and claim submissions.

Job Responsibility:

  • Accurately interprets patient insurance, prescription and other health-related documentation
  • Conducts medical insurance verifications and investigations for commercial and government payors
  • Communicates with insurance companies, patients, providers and prescribers to coordinate reimbursement and access solution
  • Reviews unpaid accounts to determine status and taking appropriate action to ensure payment
  • Reviews all claims for compliance and completeness for claims submissions
  • Researches available alternative funding options to reduce patient’s financial burden
  • Handles high call volumes
  • Communicates with internal and external departments to facilitate coordination of care
  • Maintains a high degree of confidentiality at all times due to access to sensitive information
  • Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
  • Follows all Medicare, Medicaid, and HIPAA regulations and requirements
  • Abides by all regulations, policies, procedures and standards
  • Performs other duties as assigned

Requirements:

  • High school diploma or equivalent is required
  • Undergraduate degree is preferred
  • 5 years of healthcare collections/billing experience preferred
  • Strong understanding of hospice billing regulations (Medicare, Medicaid, commercial
  • Ability to read and interpret EOBs, remittances, and denial codes
  • Effective payer follow-up and escalation strategies
  • Ability to resolve claim holds, rejections, and denial
  • Ability to identify trends in denials or delay
  • Root-cause analysis to prevent recurring issues
  • High attention to detail to ensure clean claims
  • Ability to work AR reports and aging summaries accurately
  • Clear, professional communication with internal teams and payer reps
  • Ability to explain payer issues in plain, understandable language
  • Possess quick and accurate Alpha/numeric data entry skills
  • Computer proficiency – MS Office and Web-enabled applications strongly preferred
  • Customer service skills required
  • Maintains positive internal and external customer service relationships
  • Plans and organizes work effectively and ensures its completion
  • Meets all productivity requirements
  • Demonstrates team behavior and promotes a team-oriented environment
  • Actively participates in Continuous Quality Improvement
  • Represents the organization professionally at all times
  • Self-starter with exceptional organizational and follow-through skills
  • Ability to work independently and in a team environment
What we offer:
  • Medical, Dental and Vision Benefits
  • Continued Education
  • PTO Plan
  • Retirement Planning
  • Life Insurance
  • Employee discounts

Additional Information:

Job Posted:
January 13, 2026

Employment Type:
Fulltime
Work Type:
Remote work
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