Purchase Reimbursement Coordinator

Golden Gate Regional Center Inc; San Mateo; Hybrid; PHP 3,001,000 - 3,601,000; Full time

Benefits offered by this job

Medical benefits

Dental benefits

403(b) retirement plan

Generous time off

Job summary

Golden Gate Regional Center Inc in San Mateo, CA is hiring a Purchase Reimbursement Specialist to coordinate and process caregiver reimbursements for out-of-pocket expenses under the Early Start program. You will communicate with caregivers, verify insurance documents, and submit purchase of service authorizations for reimbursement, collaborating with service coordinators and the vendorization unit.

This hybrid role offers community engagement from our offices or remotely, with a focus on

Qualifications

• Excellent written communication skills with proper grammar and punctuation.
• Oral communication skills to convey complex information clearly and professionally.
• Familiarity with basic office equipment and software applications.
• Ability to type 60 wpm.
• Maintain confidentiality and exercise discretion.
• Basic understanding of health insurance billing terminology.

Responsibilities

• Process caregiver reimbursements for out-of-pocket expenses under Early Start.
• Coordinate with service coordinators and vendorization unit to complete reimbursements.
• Review insurance documents (EOBs, invoices, receipts) and ensure compliance with DDS/HIPAA guidelines.
• Submit purchase of service authorizations for caregiver reimbursement.
• Maintain the reimbursement email box and respond to inquiries.
• Educate caregivers on the reimbursement process and timelines.

Skills

Written communication

Oral communication

MS Office

Typing

Confidentiality

HIPAA

Education

Associate degree or equivalent

BA preferred

Tools

MS Word

MS Excel

MS PowerPoint

MS Outlook

Job description

Purchase Reimbursement Specialist

Salary Range: $47,618 - $57,141 Annually

GGRC is currently hiring for a Purchase Reimbursement Specialist. This role will coordinate and process caregiver reimbursements for out-of-pocket expenses incurred for services for an individual enrolled in the Golden Gate Regional Center (GGRC) Early Start program. Communicate and work with caregivers to obtain the needed documents from their health insurance company to be reimbursed by GGRC. Partner with service coordinators and the vendorization unit to complete reimbursement process. Submit purchase of service authorizations (POS) for caregiver reimbursement.

This is a Hybrid flex schedule role offering the opportunity to work in the community, from any of our offices located in San Francisco, San Mateo and Marin County and from the comfort of your own home.

What you’ll Do:

• Review individual serve’s eligibility for service reimbursement
  
• Communicate with caregivers verbally and via email regarding insurance coverage for the child’s early intervention services that are listed in the individualized family service plan (IFSP)
• Review and analyze insurance documents such as evidence of benefit statements, invoices, and service receipts
• Ensures compliance with policies and guidelines stated by the Department of Developmental Services (DDS)
• Maintain all client information as confidential in compliance with the federal Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the California Lanterman Act
• Review service page of individualized family service plan (IFSP)
• Communicate with insurance claims department to obtain needed documents
• Submit purchase of service authorizations for caregiver reimbursement
• Coordinate with Golden Gate Regional Center (GGRC) vendorization unit for caregiver reimbursement process
• Manage purchase reimbursement email box
• Respond to caregiver and service coordinator inquiries
• Educate caregivers on purchase reimbursement process for Early Start
• Work with Clinical Operations Manager for any cases that needs managerial guidance
• Identify and track reimbursement requests and their corresponding fiscal year due date
• Track case statuses
• Prepare copay worksheet and assemble individual packets for submission to GGRC vendorization unit
• Receive and coordinate new referrals for purchase reimbursements from service coordinators
• Track, collect stats and numbers for Early Start quarterly dashboard for reporting purposes

Who You Are:

• Written communication: ability to develop standard business communications, using proper grammar, spelling and punctuation
• Oral communication: ability to convey complex information and ideas in a clear, concise, and professional manner
• Ability to operate basic office equipment, including scanners, copiers, faxes, phones
• Basic familiarity with MS Word®, MS Excel®, MS PowerPoint®, MS Outlook® or similar software applications
• Ability to use internal records system
• Ability to type 60 wpm
• Use of discretion and ability to maintain confidentiality
• Basic understating of health insurance billing and terminology such as co-payments, coinsurance, deductibles, and evidence of benefit

• Associate Degree or equivalent, B.A Preferred
• Basic understanding of health insurance billing and terminology
• Knowledge of administrative and clerical procedures and systems, managing files and records, designing forms, and other office procedures and terminology

What are the benefits to working with GGRC?

We offer a comprehensive benefits package including Medical and Dental benefits with a generous employer contribution and additional employer paid Life, Disability and Vision coverage

10% employer contribution to a 403(b) retirement account to help you save for the future!

GENEROUS TIME OFF BENEFITS!!!

No really, we mean generous:

• 13 vacation days, 15 sick days, 11 paid holidays, 6 personal holidays, and up to 5 paid days for continuing education

What makes GGRC so special?

GGRC values diversity, we believe in creating an environment where people of all backgrounds can collaborate to find solutions to complex problems. We are community minded and passionate.

GGRC values each person as a full, robust, and unique individual and interacts with each person in a manner that is respectful and responsive. We endeavor to place each person at the center of his, her or their own life. We approach each person as an expert on his, her or their own life and identity with a clear and attentive inquiry into what is important to, as well as important for, that one person (whether coworker or person-served, family member or other stakeholder).

Golden Gate Regional Center is an Equal Opportunity Employer.