Document/Reimbursement Resource Specialist

2 months ago

Cambridge, United States Pyramid Consulting, Inc Full time

Immediate need for a talented Document/Reimbursement Resource Specialist. This is a 12+ months contract opportunity with long-term potential and is located in Cambridge, MA (Hybrid). Please review the job description below and contact me ASAP if you are interested.


Job ID: 24-48296


Pay Range: $30 - $35/hour. Employee benefits include, but are not limited to, health insurance (medical, dental, vision), 401(k) plan, and paid sick leave (depending on work location).


Key Responsibilities:


  • Assist with the verification of insurance coverage policies and benefit details through direct contact with medical insurance providers with prompt communication of accurate information to facilitate the initiation and ongoing continuation of treatment
  • Research and identify insurance company prior authorization processes and provide necessary documents and requirements to Case Management team members
  • Re-verify insurance benefits and coverage as needed to assist the Case Management Team with prompt service for Patients and Facilities.
  • Assist case management team in the resolution of co-pay claim issues related to Client Co-Pay Assistance Program
  • Coordinate within the functional Reimbursement Support Specialist team to ensure efficient assignment and distribution of tasks from the shared work queue
  • Maintain up-to-date knowledge of the reimbursement process, healthcare policy, insurance plans, payer trends, financial assistance programs, and related resources
  • Complete daily documentation of all interactions and input accurate data, which includes inbound phone calls, prescription information, insurance and PBM information, coverage approvals and/or denials, prior authorization information and ongoing coverage requirements in iCare Database while maintaining compliance with HIPAA and other applicable healthcare and privacy regulations
  • Establish proficiency and full understanding of the Client Rare Blood Disorders Patient Support Services Customer Relationship database including understanding of data elements, case statuses and outcomes, and documentation requirements
  • Receive and report all Adverse Events and Product Technical Complaints to Pharmacoviligence in accordance with Client, Rare Blood Disorders and FDA rules and regulations


Key Requirements and Technology Experience:


  • Key skills; Reimbursement , medical billing, Health Insurance
  • Reimbursement Resource Specialist
  • Bachelor’s degree required
  • 4-5 years’ experience in health insurance reimbursement, medical billing, or equivalent applicable work experience
  • Effective communication, problem-solving and negotiation skills required.
  • Ability to think critically and problem solve to address customer needs.
  • Ability to work collaboratively and independently in a fast-paced environment
  • Experience working in a high- volume patient services program preferred.
  • Experience with Salesforce CRM preferred.
  • Proficient with Microsoft Office, Word, Excel, and PowerPoint
  • Ability to be on-site 2-3 days per week.


Our client is a leading Healthcare Industry, and we are currently interviewing to fill this and other similar contract positions. If you are interested in this position, please apply online for immediate consideration.


Pyramid Consulting, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, colour, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.


By applying to our jobs you agree to receive calls, AI-generated calls, text messages, or emails from Pyramid Consulting, Inc. and its affiliates, and contracted partners. Frequency varies for text messages. Message and data rates may apply. Carriers are not liable for delayed or undelivered messages. You can reply STOP to cancel and HELP for help. You can access our privacy policy here.

  • Document/Reimbursement Resource Specialist

    2 months ago

    cambridge, United States Pyramid Consulting, Inc Full time

    Immediate need for a talented Document/Reimbursement Resource Specialist. This is a 12+ months contract opportunity with long-term potential and is located in Cambridge, MA (Hybrid). Please review the job description below and contact me ASAP if you are interested. Job ID: 24-48296Pay Range: $30 - $35/hour. Employee benefits include, but are not limited to,...

  • Medical Reimbursement Specialist

    3 weeks ago

    Cambridge, Massachusetts, United States Randstad Full time

    **Overview of the Position**Randstad is a world leader in matching great people with great companies. We are currently seeking a highly skilled Medical Reimbursement Specialist to join our team.Salary: The estimated salary for this position is $36.25-$36.26 per hour.Job DescriptionThe Medical Reimbursement Specialist will be responsible for assisting with...

  • Clinical Reimbursement Specialist

    6 days ago

    Cambridge, Massachusetts, United States Adecco US, Inc. Full time

    Adecco US, Inc. is seeking a skilled Reimbursement Resource Specialist to join our team in Cambridge, MA.This role offers an estimated hourly wage of $35-$36.25, depending on experience and qualifications.Job Description:Support and collaborate with Case Managers in Rare Blood Disorders businessAssist with enrollment processing and facilitate reimbursement...

  • Lead Clinical Documentation Improvement and Reimbursement Specialist

    3 weeks ago

    Cambridge, Massachusetts, United States Mass General Brigham Full time

    About the RoleWe are seeking a skilled Lead Clinical Documentation Improvement and Reimbursement Specialist to join our team in post-acute care. This role will be responsible for facilitating improvement in the overall quality, completeness, and accuracy of medical record documentation.Key ResponsibilitiesProvides education to the CDI team on documentation...

  • Reimbursement Specialist

    3 months ago

    cambridge, United States Vinfen Full time

    Schedule: Mon-Fri 9am-5pm (2 days remote after training) Salary: $23.00-$25.00 / hour Required to have mental health billing experience The Reimbursement Specialist is charged with coordinating the analysis and effective resolution of denied claims with the purpose of reducing overall denials and increasing revenue. The Reimbursement Specialist is...

  • Reimbursement Specialist

    5 months ago

    Cambridge, United States Vinfen Full time

    Schedule: Mon-Fri 9am-5pm (2 days remote after training) Salary: $23.00-$25.00 / hour Required to have mental health billing experience The Reimbursement Specialist is charged with coordinating the analysis and effective resolution of denied claims with the purpose of reducing overall denials and increasing revenue. The Reimbursement Specialist is...

  • Reimbursement Specialist

    2 months ago

    cambridge, United States Vinfen Full time

    Schedule: Mon-Fri 9am-5pm (2 days remote after training) Salary: $23.00-$25.00 / hour Required to have mental health billing experience The Reimbursement Specialist is charged with coordinating the analysis and effective resolution of denied claims with the purpose of reducing overall denials and increasing revenue. The Reimbursement Specialist is...

  • Senior Clinical Document Specialist

    3 weeks ago

    Cambridge, Massachusetts, United States Integrated Resources, Inc ( IRI ) Full time

    About the Role:We are seeking a highly motivated and experienced Senior Clinical Document Specialist to join our team at Integrated Resources, Inc. (IRI). This is an exciting opportunity for someone with expertise in clinical document management and eTMF systems.As a Senior Clinical Document Specialist, you will be responsible for managing clinical documents...

  • Senior Quality Document Coordinator

    3 weeks ago

    Cambridge, Massachusetts, United States Integrated Resources, Inc ( IRI ) Full time

    Company Overview">Integrated Resources, Inc (IRI) is a leading provider of quality document control solutions.">About the Role">We are seeking a highly organized and detail-oriented Quality Control Document Specialist to join our team in Cambridge, MA.">Job Description:">The Quality Control Document Specialist will be responsible for managing GxP...

  • Clinical Document Management Specialist

    3 weeks ago

    Cambridge, Massachusetts, United States Proclinical Staffing Full time

    We are seeking a skilled Clinical Document Management Specialist to join our team at Proclinical Staffing in Cambridge, MA. As a Clinical Document Management Specialist, you will play a critical role in ensuring the accuracy and timeliness of clinical documents, including Trial Master Files (TMFs). You will be responsible for managing clinical document...

  • Human Resources Operations Specialist

    3 weeks ago

    Cambridge, Massachusetts, United States Planet Professional Full time

    Job Title:Human Resources Operations SpecialistAbout the Role:We are seeking a skilled Human Resources Representative to join our team at Planet Professional. As an HRIS & People Operations Specialist, you will be responsible for processing employee data changes in a timely manner and troubleshooting system issues.Responsibilities:Data Management: Process...

  • Quality Document Control Specialist

    2 months ago

    Cambridge, United States Integrated Resources, Inc ( IRI ) Full time

    Description: Role: Quality Document Control Specialist, Contractor I Location: Cambridge, MA Job Type: 6 months on W2 Contract Job Description: Duties: Veeva GxP Documentation and archival Processing, Sorting, Organization and archival of on-site GxP archives and digital archives Projects related to GxP documentation Assist with the administration of GxP...

  • Quality Document Control Specialist

    2 months ago

    cambridge, United States Integrated Resources, Inc ( IRI ) Full time

    Description: Role: Quality Document Control Specialist, Contractor I Location: Cambridge, MA Job Type: 6 months on W2 Contract Job Description: Duties: Veeva GxP Documentation and archival Processing, Sorting, Organization and archival of on-site GxP archives and digital archives Projects related to GxP documentation Assist with the administration of GxP...

  • Quality Document Control Specialist

    7 months ago

    Cambridge, United States Integrated Resources, Inc ( IRI ) Full time

    Description: Role: Quality Document Control Specialist, Contractor I Location: Cambridge, MA Job Type: 6 months on W2 Contract Job Description: Duties: Veeva GxP Documentation and archival Processing, Sorting, Organization and archival of on-site GxP archives and digital archives Projects related to GxP documentation Assist with the administration of GxP...

  • Human Resources Operations Specialist

    1 month ago

    Cambridge, United States Planet Professional Full time

    HRIS & People Operations SpecialistContract6 months Process: video interview Industry: Biotech, public company, about 650 employeesHours: 40 hours per weekLocation: Hybrid in Cambridge, MA (2-3 days onsite at Sidney St - close to Central Square) Vaccinated: yesMust haves:-2+ years of HR operations experience-Has used HR systems-MS Office-Vaccinated for...

  • Human Resources Operations Specialist

    4 weeks ago

    Cambridge, United States Planet Professional Full time

    HRIS & People Operations SpecialistContract6 months Process: video interview Industry: Biotech, public company, about 650 employeesHours: 40 hours per weekLocation: Hybrid in Cambridge, MA (2-3 days onsite at Sidney St - close to Central Square) Vaccinated: yesMust haves:-2+ years of HR operations experience-Has used HR systems-MS Office-Vaccinated for...

  • Human Resources Development Specialist

    3 weeks ago

    Cambridge, Massachusetts, United States Integrated Resources, Inc ( IRI ) Full time

    Job SummaryWe are seeking an experienced Human Resources Development Specialist to join our team at Integrated Resources, Inc. (IRI). This role will play a key part in shaping the workforce and culture for our USA and Canada sites.The successful candidate will contribute to the implementation of learning and development activities, including onboarding,...

  • Document Coordinator

    6 months ago

    Cambridge, United States PSG Global Solutions Careers Full time

    Apply now and our proprietary system will quickly have you in front of a live recruiter. The Opportunity Description We're looking for a Document Coordinator, working in Pharmaceuticals and Medical Products industry in 300 Third Street, Cambridge, Massachusetts, 02142, United States. Maintains metrics for periodic review Makes updates in Veeva based on...

  • Medical Reimbursement Expert

    3 weeks ago

    Cambridge, Massachusetts, United States Pyramid Consulting, Inc Full time

    We are seeking a skilled Medical Reimbursement Expert to join our team in Cambridge, MA. This is a 12+ month contract opportunity with long-term potential.As a Medical Reimbursement Expert, you will be responsible for verifying insurance coverage policies and benefit details through direct contact with medical insurance providers. You will also research and...

  • Human Resources Business Partner

    3 weeks ago

    Cambridge, Maryland, United States TreeHouse Foods Full time

    At TreeHouse Foods, we are committed to building a performance-based culture where employees can do their best work and develop their careers. This is an exciting opportunity for a Human Resources Specialist to join our Cambridge, MD plant as a key member of the HR team.About UsTreeHouse Foods is a leading manufacturer of private label packaged foods and...