Reimbursement Specialist II

Jobtailor; Deutschland; Remote; EUR 42.000 - 64.000; Vollzeit

Benefits dieser Stelle

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Zusammenfassung

Jobtailor is seeking a detail-oriented Healthcare Reimbursement Specialist to track, resolve, and appeal complex claims. You will work with EOBs, state and external review processes, and collaborate with billing teams to optimize reimbursement.

The role requires 2+ years in reimbursement, strong Excel skills, knowledge of payer portals, Xifin, and the ability to work PST hours in a fast-paced environment.

Qualifikationen

• 2+ years’ experience in a healthcare reimbursement role.
• Solid understanding of health plan regulations, billing processes, and payer interactions.
• Experience with appeals at state and external review levels (IRO/IRBs) is preferred.
• Organized with strong attention to detail.
• Self-starter capable of working independently with minimal supervision.
• Tech-savvy and analytical, able to troubleshoot complex issues.
• Excellent written and verbal communication skills, especially in challenging scenarios.
• Moderate proficiency in Excel (sorting, filtering, basic calculations).
• Familiarity with laboratory billing, Xifin, EDI enrollment, payer portals, merchant solutions, and national/regional payers is a plus.
• Ability to work PST hours
• Background screening including criminal history is required
• Ability to sit for extended periods of time
• May be required to lift routine office supplies and use office equipment

Aufgaben

• Track, report, and resolve complex outstanding claims
• Troubleshoot Explanation of Benefits (EOBs) and identify reasons for claim denials or low payments
• Appeal non-covered or underpaid claims through external review channels
• Follow up on unpaid claims to ensure timely resolution
• Drive positive coverage determinations through external appeals
• Maintain accurate documentation of payer communications, correspondence, and insurance research
• Collaborate with the billing tool provider, finance, and client services teams to streamline billing operations and optimize reimbursement processes

Kenntnisse

Claims Tracking

Appeals Management

Billing Processes

EOB Troubleshooting

Documentation Maintenance

Insurance Research

Analytical Skills

Attention to Detail

Independent Work

Problem Solving

Tools

Xifin

EDI Enrollment

Payer Portals

Billing Tool Provider

Merchant Solutions

Jobbeschreibung

• Track, report, and resolve complex outstanding claims
• Troubleshoot Explanation of Benefits (EOBs) and identify reasons for claim denials or low payments
• Appeal non-covered or underpaid claims through external review channels
• Follow up on unpaid claims to ensure timely resolution
• Drive positive coverage determinations through external appeals
• Maintain accurate documentation of payer communications, correspondence, and insurance research
• Collaborate with the billing tool provider, finance, and client services teams to streamline billing operations and optimize reimbursement processes

Requirements

• 2+ years’ experience in a healthcare reimbursement role
• Solid understanding of health plan regulations, billing processes, and payer interactions
• Experience with appeals at state and external review levels (IRO/IRBs) is preferred
• Organized with strong attention to detail
• Self-starter capable of working independently with minimal supervision
• Tech-savvy and analytical, able to troubleshoot complex issues
• Excellent written and verbal communication skills, especially in challenging scenarios
• Moderate proficiency in Excel (sorting, filtering, basic calculations)
• Familiarity with laboratory billing, Xifin, EDI enrollment, payer portals, merchant solutions, and national/regional payers is a plus
• Ability to work PST hours
• Background screening including criminal history is required
• Ability to sit for extended periods of time
• May be required to lift routine office supplies and use office equipment

Demonstrates expertise in healthcare reimbursement processes, including claims tracking, appeals management, and payer interactions, while maintaining strong organizational skills and attention to detail.

Highest-signal resume keywords

• Healthcare Reimbursement Experience
• Claims Tracking and Resolution
• Appeals Management
• Payer Interactions
• Excel Proficiency

ATS Optimization Keywords

Hard Skills

• Claims Tracking
• Appeals Management
• Billing Processes
• EOB Troubleshooting
• Documentation Maintenance
• Insurance Research
• Analytical Skills
• Attention to Detail
• Independent Work
• Problem Solving

Soft Skills

• Excellent Communication Skills
• Organizational Skills
• Self-Starter

Industry Keywords

• Health Plan Regulations
• Payer Interactions
• Laboratory Billing
• External Review Channels
• National Payers
• Regional Payers

Tools & Technologies

• Xifin
• EDI Enrollment
• Payer Portals
• Billing Tool Provider
• Merchant Solutions