Reimbursement Specialist

4 days ago


Downers Grove, Illinois, United States Ambercare Full time
Reimbursement Specialist Job Description

We are seeking a highly skilled Reimbursement Specialist to join our team at Ambercare. As a Reimbursement Specialist, you will play a critical role in ensuring accurate and timely reimbursement for our patients.

Key Responsibilities:
  • Accurately interpret patient insurance, prescription, and other health-related documentation
  • Conduct medical insurance verifications and investigations for commercial and government payors
  • Communicate with insurance companies, patients, providers, and prescribers to coordinate reimbursement and access solutions
  • Review unpaid accounts to determine status and take appropriate action to ensure payment
  • Review all claims for compliance and completeness for claims submissions
  • Research available alternative funding options to reduce patient financial burden
  • Handle high call volumes
  • Communicate with internal and external departments to facilitate coordination of care
  • Maintain a high degree of confidentiality at all times due to access to sensitive information
  • Maintain regular, predictable, consistent attendance and be flexible to meet the needs of the department
  • Follow all Medicare, Medicaid, and HIPAA regulations and requirements
  • Abide by all regulations, policies, procedures, and standards
Requirements:
  • High school diploma or equivalent is required; undergraduate degree is preferred
  • Experience in medical billing, accounts receivables, and/or collections within a healthcare or insurance environment is preferred
  • Possess quick and accurate Alpha/numeric data entry skills
  • Computer proficiency - MS Office and Web-enabled applications strongly preferred
  • Understanding of the requirements of Medicaid, Medicare, and Insurance billing is preferred
  • Maintain positive internal and external customer service relationships


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