Reimbursement Specialist
19 hours ago
We are seeking a highly skilled Reimbursement Specialist to join our team at Addus Homecare. As a Reimbursement Specialist, you will be responsible for billing and revenue cycle management, including insurance benefit investigation, authorization requests, and claim submissions.
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
- 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
- Customer service skills required
- Understanding of the requirements of Medicaid, Medicare, and insurance billing is preferred
- Maintain positive internal and external customer service relationships
- Maintain open lines of communication
- Plans and organizes work effectively and ensures its completion
- Meets all productivity requirements
- Demonstrates team behavior and promotes a team-oriented environment
- Actively participates in Continuous Quality Improvement
- Represents the organization professionally at all times
- Self-starter with exceptional organizational and follow-through skills
- Excellent verbal and written communication skills
- Ability to work independently and in a team environment
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