Reimbursement Specialist Job at Arcadia Home Care and Staffing

Reimbursement Specialist

In this role you will perform Reimbursement Specialist duties for assigned terri...

Location

United States , Saint Paul

Salary:

49600.00 - 68200.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

3+ years of industry experience, preferably in health insurance and/or durable medical equipment
Third party payer experience strongly preferred
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment
Possess the ability to manage time and prioritize critical priorities
Proficiency in Microsoft Office Software
Experience with Total Information Management System (TIMS) a benefit

Job Responsibility

Perform verification of eligibility and benefits to determine coverage and payer requirements
Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
Gather clinical documentation to support medical necessity for Cardiology products and assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid
Process authorization decisions from payers timely to streamline and drive revenue
Negotiate payment rates for letter of agreement to ensure maximum collection potential
Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams
Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Time-off benefits such as paid holidays, paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave
Commuting benefits

Fulltime

Reimbursement Specialist

In this role you will perform Reimbursement Specialist duties for assigned terri...

Location

United States , Saint Paul

Salary:

49600.00 - 68200.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

3+ years of industry experience, preferably in health insurance and/or durable medical equipment
Third party payer experience strongly preferred
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment
Possess the ability to manage time and prioritize critical priorities
Proficiency in Microsoft Office Software
Experience with Total Information Management System (TIMS) a benefit

Job Responsibility

Perform verification of eligibility and benefits to determine coverage and payer requirements
Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
Gather clinical documentation to support medical necessity for Cardiology products and assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid
Process authorization decisions from payers timely to streamline and drive revenue
Negotiate payment rates for letter of agreement to ensure maximum collection potential
Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams
Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance

What we offer

medical and dental coverage start on day one
insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts
educational assistance programs
time-off benefits such as paid holidays, paid time off ranging from 20 to 35 days based on length of service, family and medical leaves of absence, and paid parental leave
commuting benefits
Employee Discount Program
Employee Assistance Program (EAP)

Fulltime

Reimbursement Specialist

In this role you will perform Reimbursement Specialist duties for assigned terri...

Location

United States , Saint Paul

Salary:

49600.00 - 68200.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

3+ years of industry experience, preferably in health insurance and/or durable medical equipment
Third party payer experience strongly preferred
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment
Possess the ability to manage time and prioritize critical priorities
Proficiency in Microsoft Office Software
Experience with Total Information Management System (TIMS) a benefit

Job Responsibility

Perform verification of eligibility and benefits to determine coverage and payer requirements
Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
Gather clinical documentation to support medical necessity for Cardiology products and assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid
Process authorization decisions from payers timely to streamline and drive revenue
Negotiate payment rates for letter of agreement to ensure maximum collection potential
Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams
Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP), with the ability to purchase company stock at a discount
401(k) Retirement Savings Plan (RSP), with options for employee contributions and company matching
Flexible Spending Accounts
Educational assistance programs
Paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

Reimbursement Specialist

Our team members are at the heart of everything we do. At Cencora, we are united...

Location

Canada

Salary:

41800.00 - 64350.00 CAD / Year

Cencora

Expiration Date

Until further notice

Requirements

Post-secondary education or equivalent in a related discipline
Minimum of 2 years experience in customer service, in an office setting
Strong proficiency in Microsoft applications (Outlook, Word, Excel)
Professional / courteous / efficient telephone manner
Proven ability to organize time, set priorities and multi-task in order to meet various competing work deadlines
Candidate must have strong communication and interpersonal skills
Ability to work independently and in a team environment
Attention to detail
Experience in the healthcare, pharmaceutical or insurance industry is an asset
Bilingualism, French/English is an asset

Job Responsibility

Coordinate and manage all aspects required in order to obtain prescription drug coverage for patients
Coordinate cases with insurance companies, physician’ offices and healthcare professionals in order to maximize reimbursement solutions
Coordinate documents, submissions and all related paperwork to insurance companies, public/federal funding programs
Implement Financial Means Test as required in an effort to maximize patient’s prescription drug coverage
Coordinate pharmacy processes required once funding has been obtained
Acquire in depth knowledge of public / private and federal funding mechanisms
Report all Adverse Events to the assigned units/departments
Be assigned other duties and tasks as required from time to time

What we offer

Medical, dental, and vision care
Comprehensive suite of benefits focusing on physical, emotional, financial, and social aspects of wellness
Support for working families (backup dependent care, adoption assistance, infertility coverage, family building support)
Behavioral health solutions
Paid parental leave
Paid caregiver leave
Training programs
Professional development resources
Opportunities to participate in mentorship programs, employee resource groups, volunteer activities

Fulltime

Reimbursement Specialist

Our team members are at the heart of everything we do. At Cencora, we are united...

Location

Canada

Salary:

Not provided

Cencora

Expiration Date

Until further notice

Requirements

Post-secondary education or equivalent in a related discipline
Minimum of 2 years experience in customer service, in an office setting
Strong proficiency in Microsoft applications (Outlook, Word, Excel)
Professional / courteous / efficient telephone manner
Proven ability to organize time, set priorities and multi-task in order to meet various competing work deadlines
Candidate must have strong communication and interpersonal skills
Ability to work independently and in a team environment
Attention to detail
Experience in the healthcare, pharmaceutical or insurance industry is an asset
Bilingualism, French/English is an asset

Job Responsibility

Coordinate and manage all aspects required in order to obtain prescription drug coverage for patients
Coordinate cases with insurance companies, physician’ offices and healthcare professionals in order to maximize reimbursement solutions
Coordinate documents, submissions and all related paperwork to insurance companies, public/federal funding programs
Implement Financial Means Test as required in an effort to maximize patient’s prescription drug coverage
Coordinate pharmacy processes required once funding has been obtained
Acquire in depth knowledge of public / private and federal funding mechanisms
Report all Adverse Events to the assigned units/departments
Be assigned other duties and tasks as required from time to time

What we offer

Medical, dental, and vision care
Backup dependent care
Adoption assistance
Infertility coverage
Family building support
Behavioral health solutions
Paid parental leave
Paid caregiver leave
Training programs
Professional development resources

Fulltime

Reimbursement Specialist

In this role you will perform Reimbursement Specialist duties for assigned terri...

Location

United States , Saint Paul

Salary:

49600.00 - 68200.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

3+ years of industry experience, preferably in health insurance and/or durable medical equipment
Third party payer experience strongly preferred
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment
Possess the ability to manage time and prioritize critical priorities
Proficiency in Microsoft Office Software

Job Responsibility

Perform verification of eligibility and benefits to determine coverage and payer requirements
Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
Gather clinical documentation to support medical necessity for Cardiology products and assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid
Process authorization decisions from payers timely to streamline and drive revenue
Negotiate payment rates for letter of agreement to ensure maximum collection potential
Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams
Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts
Educational assistance programs
Paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

Reimbursement Specialist

Perform Reimbursement Specialist duties for assigned territory or payer(s) inclu...

Location

United States , Saint Paul

Salary:

49600.00 - 68200.00 USD / Year

Baxter

Expiration Date

Until further notice

Requirements

3+ years of industry experience, preferably in health insurance and/or durable medical equipment
Third party payer experience strongly preferred
Exceptional written, verbal, and interpersonal communications
Strong critical thinking and problem-solving skills
Detail orientated and ability to multi-task
Ability to work independently as well as in a team environment
Possess the ability to manage time and prioritize critical priorities
Proficiency in Microsoft Office Software

Job Responsibility

Perform verification of eligibility and benefits to determine coverage and payer requirements
Ensure all benefit information is loaded correctly to reduce rework and allow for clean claims
Gather clinical documentation to support medical necessity for Cardiology products
Assess clinical documentation to ensure all applicable prescription, face to face, and coverage criteria requirements are met
Prepare and submit prior authorization requests to insurance companies including commercial payers as well as government payers including Medicare and Medicaid
Process authorization decisions from payers timely to streamline and drive revenue
Negotiate payment rates for letter of agreement to ensure maximum collection potential
Provide a superior customer experience by leveraging ability to discuss payer policies, coverage criteria, benefit limitations, potential cost, or any pertinent product information with patients and healthcare teams
Understand and adhere to all policies for Baxter and 3rd party payers to ensure the highest standards of quality and compliance
Consistently contribute to team goals and understand how they support greater organizational goals

What we offer

Medical and dental coverage that start on day one
Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
Employee Stock Purchase Plan (ESPP)
401(k) Retirement Savings Plan (RSP)
Flexible Spending Accounts
Educational assistance programs
Paid holidays
Paid time off ranging from 20 to 35 days based on length of service
Family and medical leaves of absence
Paid parental leave

Fulltime

Reimbursement Specialist

The Reimbursement Specialist (Skilled Reimbursement/Hospice) will be responsible...

Location

United States , Frisco

Salary:

Not provided

Arcadia Home Care and Staffing - an Addus family company

Expiration Date

Until further notice

Requirements

High school diploma or equivalent is required
Undergraduate degree is preferred
Hospice Room & Board collections preferred, but general Hospice Collections experience acceptable
Experience in Medical Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment is preferred
Possess quick and accurate Alpha/numeric data entry skills
Computer proficiency – MS Office and Web-enabled applications strongly preferred
Customer service skills required
Understanding of the requirements of Medicaid, Medicare and Insurance billing is preferred
Maintains positive internal and external customer service relationships
Maintains open lines of communication

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

What we offer

Medical, Dental and Vision Benefits
Continued Education
PTO Plan
Retirement Planning
Life Insurance
Employee discounts

Fulltime

Select Country

Reimbursement Specialist

Job Description

Job Responsibility

Requirements

What we offer

Looking for more opportunities?

Reimbursement Specialist

Reimbursement Specialist

Reimbursement Specialist

Reimbursement Specialist

Reimbursement Specialist

Reimbursement Specialist

Reimbursement Specialist

Reimbursement Specialist

Reimbursement Specialist

Our AI answers in your language