Reimbursement Specialist llI (Beverly Hills, CA)

AmeriPharma • Beverly Hills, CA

1d • $31 - $34 • Onsite

About The Position

We are seeking a highly skilled Reimbursement Specialist to join our dynamic team. The ideal candidate will be responsible for ensuring accurate and timely collections to maximize reimbursement experience. This role is essential in ensuring accurate and timely collections and maximizing reimbursement through effective interactions with third-party payers, insurance plans, and patients. The candidate will possess strong analytical skills, be detail-oriented, and excel in submitting claims, appeals, and resolving discrepancies with minimal supervision.

Requirements

• Ability to read, write, speak, and understand the English language fluently.
• Ability to collaborate with other team members and management for all pharmacy needs.
• Strong time management, communication, multitasking and organizational skills.
• High attention to detail and strong analytical and problem-solving skills.
• Ability to work collaboratively in a fast-paced team environment.
• Ability to work independently and meet deadlines with minimal supervision.
• Strong attention to detail with the ability to type accurately and analyze data.
• Ability to apply logical thinking to solve complex and practical problems.
• Flexible and able to work hours that ensure timely completion of projects and duties.
• High School Diploma or equivalent.
• Minimum of 3 years of hands-on experience in medical collections and reimbursement experience.
• In depth Knowledge of managed care, commercial insurance, ICD-10, CPT, HCPC codes, J billing codes, and medical terminology, along with CMS HCFA 1500 forms & Electronic Billing.
• Experience with Benefit Investigation and Patient Responsibility Agreements.
• Experience with automated billing systems, CPR+ is preferred.
• Advanced proficiency in Microsoft Word, Excel, and Outlook.

Responsibilities

• Reviews patient inventory of assigned accounts
• Collects on all open AR inventory to ensure reimbursements are received within 60 days of billed date
• Work on all correspondences assigned before due dates
• Reviews contracts and fee schedules to ensure accurate reimbursements
• Correlating insurance coverage with services to be provided
• Preparation and review of insurance claims
• In-depth understanding of healthcare billing and coding processes
• Navigate complicated insurance policies and regulations
• Evaluates payments received to ensure that reimbursement received is accurate
• Maintains a positive DSO on assigned account inventory
• Provides the highest level of customer service in answering patient phone calls and resolve patients’ questions and/or billing issues, as well as communicate with doctors’ offices and their staff
• Assists in account collections activities as needed
• Ensures compliance with all payer rules, regulations along with company policies & procedures
• Perform other duties assigned by management

Benefits

• Full benefits package including medical, dental, vision, and life
• Great pay and general compensation structures
• Employee assistance program to assist with mental health, legal questions, financial counseling, etc.
• Comprehensive PTO and sick leave options
• 401k and matching programs
• Plenty of opportunities for growth and advancement
• Company sponsored outings and team-building events
• Casual Fridays

What This Job Offers

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