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Reimbursement Specialist

3 months ago

Beverly, United States Pride Health Full time

Reimbursement Specialist


Pride Health is hiring an Administrative - Reimbursement Specialist for one of its clients. This is a fully Remote opportunity.

This is a pure 3-month contract opportunity with competitive pay and benefits. This position can be in an office, hybrid, or remote


Job Title: Reimbursement Specialist

Pay Range: $13.00/hr. to $14.00/hr.

Location: Beverly, MA (01915)

Duration: 3 months + Possible Extension

Shift: M-F - 8:00 AM - 5:30 PM


Job Summary

The Billing & Reimbursement Specialist I is assigned a group of dialysis facilities and is responsible for the accurate and efficient billing and collecting of health insurance payments from insurance carriers. The Billing and Reimbursement Specialist coordinates, documents, and communicates with health insurance representatives regarding proper insurance payments by policies and procedures and current federal, state, and local standards, guidelines, and regulations.


Job Duties

  • Responsible for accurate billing and collecting of revenue for respective financial classes.
  • Obtains and tracks claim status via phone and online portals.
  • Composes and follows up on claims appeals.
  • Appropriately identifies, addresses, submits, and processes adjustments.
  • Reviews and understands Explanation of Benefits.
  • Builds effective relationships with insurance carriers and representatives.
  • Allocates coinsurance and deductibles timely and appropriately within the applicable database.
  • Responsible for reviewing and addressing incoming mail correspondence.
  • Communicates effectively with patients regarding insurance checks.
  • Communicates and collaborates with other internal departments.
  • Adapts and is flexible when change arises and demonstrates a willingness to learn new skills.
  • Approaches work with the organization, attention to detail, and maintain high standards of accuracy.
  • Completes and maintains facility reports regularly and reviews for any issues.
  • Maintains strict confidentiality of patient personal information.
  • Maintains HIPAA compliance.
  • Understand the business implications of decisions.
  • Performs additional tasks, duties, and projects as assigned.


Requirements

  • Bachelor’s degree with a focus in business or healthcare management - REQUIRED
  • 2 years experience as a billing and reimbursement specialist, or equivalent work experience with medical insurance providers - REQUIRED
  • Dialysis or healthcare experience - REQUIRED
  • Proficiency in Microsoft Office Suite - REQUIRED
  • Knowledge of Excel, PivotTable, and VLOOKUP – REQUIRED


Pride Global offers eligible employees comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance, and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance, and employee discounts with preferred vendors.


As a certified minority-owned business, Pride Global and its affiliates - including Russell Tobin, Pride Health, and Pride Now - are committed to creating a diverse environment and are proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, pregnancy, disability, age, veteran status, or other characteristics.