Reimbursement Specialist

2 days ago

Frisco, Texas, United States Addus HomeCare Full time
About the Role

We are seeking a highly skilled Reimbursement Specialist to join our team at Addus HomeCare. 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 to ensure compliance with regulatory requirements.
  • Conduct thorough medical insurance verifications and investigations for commercial and government payors to identify potential reimbursement opportunities.
  • Communicate effectively 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 and maintain a high degree of confidentiality at all times due to access to sensitive information.
  • Communicate with internal and external departments to facilitate coordination of care.
  • 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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