Senior Reimbursement Specialist

3 weeks ago

Staten Island NY, United States AdaptHealth LLC Full time

At AdaptHealth we offer full-service home medical equipment products and services to empower patients to live their best lives – out of the hospital and in their homes. If you are passionate about making a profound impact on the quality of patients' lives, please click to apply, we would love to hear from you.

The PAP Specialist has a broad range of responsibilities including accurate and timely data entry, understanding, and selecting inventory and services in key databases, communicating with referral sources, and appropriately utilizing technology to notate patient information/communication. Responsible for ensuring customers receive PAP equipment by scheduling an appointment for the customer to come in to pick up equipment and receive proper instruction on how to best use the equipment. Explains customers financial responsibility and ensure payment.
PAP Specialists are responsible for preparing and submitting audit paperwork for Medicare and other insurance claims to ensure continued compliance with healthcare guidelines. The PAP Specialist will accurately respond to claim audits and communicate audit results in such a way to provide education and appropriate process changes that directly impact the daily functions of AdaptHealth.
Responsible for monitoring, communicating, and managing all clients on Positive Airway Pressure devices. Responsible for encouraging client compliance with PAP equipment and program.

Develop and maintain working knowledge of current HME products and services offered by the company and all applicable insurance guidelines respecting eligibility for coverage and reimbursement.
Is actively involved in team activities, evidenced by participation, mentoring, and training with co-workers
Assists in the development and maintenance of reference materials for use by staff and facilitates the sharing of information
Responsible for entering data in an accurate manner, into database including although not limited to payer, authorization requirements, coverage limitations and status of any requalification
Collaborates with physician offices, AdaptHealth sales and support staff to ensure timely receipt of documentation as well as educating, as necessary.
Completes assigned compliance training and other educational programs as required
One (1) year work related experience in health care administrative, financial, or insurance customer services, claims, billing, call center or management regardless of industry.
Senior level requires two (2) years of work-related experience and one (1) year of exact job experience.
Exact job experience is considered any of the above tasks in a Medicare certified HME, Diabetic, Pharmacy, or home medical supplies environment that routinely bills insurance.

AdaptHealth is an equal opportunity employer and does not unlawfully discriminate against employees or applicants for employment on the basis of an individual's race, color, religion, creed, sex, national origin, age, disability, marital status, veteran status, sexual orientation, gender identity, genetic information, or any other status protected by applicable law. This policy applies to all terms, conditions, and privileges of employment, including recruitment, hiring, placement, compensation, promotion, discipline, and termination.

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