Reimbursement Specialist

Role Overview

• Researching and monitoring specific billing issues, trends and potential risks
• Reviewing and ensuring claims are submitted accurately with all pre-claim requirements
• Tracking the status of claims and pulling reports to manage work
• Reviewing denied/unpaid claims and taking appropriate corrective action
• Providing administrative support for department(s) including data entry and record keeping
• Navigating payor portals to check eligibility, prior authorization, claim or appeal statuses
• Assisting patients with navigating the financial journey with compassion and accuracy
• Verifying insurance/recipient benefits with Medicare, Medicaid and Private Insurer Payers

Requirements

• High school diploma or GED
• Associate's or bachelor's degree in healthcare administration, business, or related field preferred
• 2+ years of experience in medical billing, insurance claims, or revenue cycle operations
• Familiarity with HIPAA compliance and healthcare privacy regulations
• Experience with payer portals and claim tracking systems
• Strong attention to detail and organizational skills
• Proficiency in Microsoft Office (especially Word and Excel)

Benefits

• Competitive compensation
• Health insurance
• Paid time off
• Flexible working arrangements
• Professional development opportunities