Reimbursement Specialist

Job Responsibilities

• Collections of third-party payor accounts for assigned payers
• Ensure proper follow-up is performed on all aspects of the revenue cycle related to reimbursement, including projects, problem and issues escalation, denials management and research
• Maintain and update shared documentation to assist Intake Team with the various policies, rules and limitations for insurance plans
• Identify adjustments, payment trends and denials and ensure problems are escalated as necessary
• Maintain confidentiality in all aspects of patient care, employee activities and office environment
• Communicate changes regularly or as often as needed
• Work collaboratively with other department staff such as Intake & Reauthorization Specialist to ensure timely collections
• Assist the PBM and Billing Specialist with issues, billing backlogs and end-of-month processes
• Field and troubleshoot calls from patients regarding benefit, claims and patient balances
• Pro-actively seek resolutions to any billing issues that may arise
• Perform CPR+/Caretend related transactions accurately and timely
• Perform other duties as assigned

Requirements

• High School Diploma or equivalent
• 2-3 years of experience in electronic claims submission and medical collections preferred
• Working knowledge of insurance plans including Medicare and Medicaid required
• Industry experience with billing/collections in DME, home infusion and/or enteral preferred
• Accounts receivable and accounting experience preferred
• Knowledge of CPR+ and/or Caretend software preferred

Qualifications

• Detail-oriented individual with a passion for healthcare billing and collections

Skills

• Proficient in all phases of insurance data collection, verification, and authorization
• Documentation and computer input of the new referral and subsequent patient admission from start to finish

Benefits & Perks

• Comprehensive Medical, Dental, and Vision Package
• 401(k) Plan with Company Match
• Generous PTO: Vacation, Sick Time, Personal Days, and Paid Holidays
• Life Insurance: Standard coverage with optional enhancements
• Employee Assistance Program: Free counseling and coaching sessions
• Emotional Well-being and Work-Life Balance Resources
• Short & Long-Term Disability: Company-paid with optional supplements
• Accidental Death and Dismemberment Insurance
• FSA and HSA: Manage healthcare expenses
• Commuter Spending Programs
• Volunteer and Engagement Opportunities
• Employee Referral Bonuses
• Exclusive Discounts on entertainment, travel and various other supplemental and cellphone plans

Physical Demands

• Regularly talk and listen
• Frequently stand and walk
• Occasionally lift up to 35 pounds

About the Role

The Reimbursement Specialist will play a crucial role in the AR Infusion team, ensuring accurate and timely patient billing and collections. This position requires a high level of attention to detail and strong communication skills.

Schedule

Flexible eight (8) hour shifts, earliest starting at 8:00am

Location

Hybrid out of New Providence, NJ

EEO Statement

The PromptCare Companies is committed to Equal Employment Opportunity (EEO) and prohibits employment discrimination on the basis of race, color, age, national origin, religion, gender, gender identity, sexual orientation, pregnancy, marital status, genetic disposition, disability, veteran's status or any other characteristic or classification protected by State/Federal/Local laws. We foster a work environment in which diversity and inclusion are embraced, people are hired and advanced on their merits, and employees are treated with mutual respect and dignity.