Reimbursement Specialist - Healthcare

Your Role

• Follow up on outstanding insurance claims to secure accurate and timely payment from commercial, government, and private-pay accounts
• Monitor claim status and work to reduce aging accounts receivable
• Investigate, resolve, and respond to claim denials, unpaid claims, and payer correspondence
• Prepare and submit appeals within payer deadlines and requirements
• Review payment information, including Explanation of Benefits (EOBs) and Remittance Advice (RA), and process necessary adjustments, overpayments, and balance corrections
• Communicate and collaborate with insurance carriers and internal teams to resolve reimbursement issues, update insurance information, and support timely collections
• Maintain compliance with company policies, HIPAA requirements, and reimbursement procedures while supporting special projects, process improvements, and team training initiatives

You're The Right Fit If You

• Have a high school diploma or vocational education
• Have acquired 2+ years of experience in Medical Billing and Invoicing, Accounts Receivable/Payable, Contract Management or equivalent
• Have knowledge of insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield and commercial plans
• Have experience managing medical claim denials, appeals, and recoupments
• Have knowledge of insurance eligibility verification, benefits, and prior authorizations
• Must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this position
• Are an analytical and detail-oriented professional with strong problem-solving and communication skills, who thrives working independently in a fast-paced environment while maintaining a collaborative and adaptable team-focused mindset

How We Work Together

We believe that we are better together than apart. For our office-based teams, this means working in-person at least 3 days per week. Onsite roles require full-time presence in the company's facilities. Field roles are most effectively done outside of the company's main facilities, generally at the customers' or suppliers' locations. This is an office role.

About Philips

We are a health technology company. We built our entire company around the belief that every human matters, and we won't stop until everybody everywhere has access to the quality healthcare that we all deserve. Do the work of your life to help improve the lives of others.

Pay

The pay range for this position in Plymouth, MN is $24.00 to $36.00 per hour. The actual base pay offered may vary within the posted ranges depending on multiple factors including job-related knowledge/skills, experience, business needs, geographical location, and internal equity. In addition, other compensation, such as an annual incentive bonus, sales commission or long-term incentives may be offered.

Benefits

Employees are eligible to participate in our comprehensive Philips Total Rewards benefits program, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more.