Purchase Reimbursement Coordinator

Golden Gate Regional Center (GGRC); San Rafael (CA); Hybrid; USD 48,000 - 57,000; Full time

Benefits offered by this job

Medical and Dental benefits

403(b) retirement plan 10% employercon

Generous paid time off

Job summary

Golden Gate Regional Center (GGRC) is hiring a Purchase Reimbursement Specialist to coordinate caregiver reimbursements for out-of-pocket expenses under the Early Start program. You will work with caregivers to collect documents from health insurers to process reimbursements.

This hybrid role supports services across San Francisco, San Mateo, and Marin County, with work-from-home flexibility. You will ensure HIPAA/DDS compliance while partnering with service coordinators and the vendorization

Qualifications

• 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.

Responsibilities

• Review eligibility for service reimbursement.
• Communicate with caregivers about insurance coverage for IFSP services.
• Review and analyze insurance documents such as statements, invoices, and receipts.
• Ensure compliance with DDS policies and HIPAA & Lanterman Act.
• Maintain client information confidentially.
• Submit POS for caregiver reimbursement and coordinate with vendorization unit.
• Track reimbursement requests and fiscal year due dates; prepare copay worksheets.
• Answer caregiver inquiries and educate on reimbursement process.

Skills

Written communication

Oral communication

Confidentiality and discretion

Typing speed 60 wpm

Understanding of health insurance

Education

Associate degree or equivalent

B.A. preferred

Tools

MS Word

MS Excel

MS PowerPoint

MS Outlook

Internal records system

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

Requirements

• 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

Benefits

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.