Medical Reimbursement Specialist

ProCare Rx

8d • Onsite

About The Position

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Submit medical claims to appropriate payer.
Ensure resubmission of claims, when applicable, are accurate.
Ensure reimbursement of claims by submitted the most appropriate coding for
services performed.
ICD diagnosis coding, modifier application and verification of CPT and/or
HCPCS codes.
Responsible for ensuring all claims processed through Emdeon (Change
Healthcare) are correct and compliant.
Responsible for performing payer enrollment follow up·
Keeps abreast of and comply with coding guidelines and reimbursement
reporting requirements.
Daily review and follow up on all incomplete electronic provider-billing
encounters.
Identify issues, correct code and/or pend due to missing information.
Keep up to date on medical insurance rules and proper filing guideline.
Answer patient calls/questions, clinic staff calls, and insurance company
calls.
Maintain a professional relationship with insurance companies and patients.
Other duties as assigned.

QUALIFICATIONS AND REQUIREMENTS

Minimum 3 years of experience of medical ICD & CPT coding experience
preferred.
Electronic Medical Record experience, Emdeon (Change Healthcare) software
highly preferred.
Proficient with Microsoft Office Suite.
Excellent verbal and written communication skills.
Excellent organizational and time management skills.
Analytical, problem solving, and critical thinking skills.
Ability to organize, coordinate, prioritize, and facilitate on-going tasks.
Ability to work independently and with a team.

EDUCATION

High School Diploma or equivalent required.
Medical Billing/Coder Certification from accredited entity.

PHYSICAL DEMANDS
Requires sitting, standing, and occasional light lifting.

The Perks of Joining Our Team:

We believe in taking care of our team.  You'll enjoy a comprehensive benefits
package designed to support your well-being and financial future:

Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term
Disability Insurance, Life insurance.
Time to Recharge: Paid vacation and holiday pay.
Focus on Your Wellness: We offer a robust Employee Wellness Program.
Invest in Your Future: 401(k) with a company match.
Support System: Employee Assistance Program provides confidential support and
counseling.
Get Rewarded for Referring Great People:  Employee referral program.

Ready to start your rewarding journey with us? Apply today!

Please note while this job description is a comprehensive overview, additional
responsibilities may be part of the role.

ProCare Rx will never ask for a financial commitment from an applicant as part
of our recruitment process. All interviews are conducted in-person OR through
video conference invitations from official company emails. For inquiries, please
contact our recruitment team at [e-mail]. 

ProCare Rx is an Equal Opportunity Employer.

Requirements

• High School Diploma or equivalent required.
• Medical Billing/Coder Certification from accredited entity.
• Proficient with Microsoft Office Suite.
• Excellent verbal and written communication skills.
• Excellent organizational and time management skills.
• Analytical, problem solving, and critical thinking skills.
• Ability to organize, coordinate, prioritize, and facilitate on-going tasks.
• Ability to work independently and with a team.

Nice To Haves

• Minimum 3 years of experience of medical ICD & CPT coding experience preferred.
• Electronic Medical Record experience, Emdeon (Change Healthcare) software highly preferred.

Responsibilities

• Submit medical claims to appropriate payer.
• Ensure resubmission of claims, when applicable, are accurate.
• Ensure reimbursement of claims by submitted the most appropriate coding for services performed.
• ICD diagnosis coding, modifier application and verification of CPT and/or HCPCS codes.
• Responsible for ensuring all claims processed through Emdeon (Change Healthcare) are correct and compliant.
• Responsible for performing payer enrollment follow up
• Keeps abreast of and comply with coding guidelines and reimbursement reporting requirements.
• Daily review and follow up on all incomplete electronic provider-billing encounters.
• Identify issues, correct code and/or pend due to missing information.
• Keep up to date on medical insurance rules and proper filing guideline.
• Answer patient calls/questions, clinic staff calls, and insurance company calls.
• Maintain a professional relationship with insurance companies and patients.
• Other duties as assigned.

Benefits

• Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
• Paid vacation and holiday pay.
• Employee Wellness Program.
• 401(k) with a company match.
• Employee Assistance Program provides confidential support and counseling.
• Employee referral program.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED