Reimbursement Coordinator - Home Infusion

WellSky Financial Services; United States; Remote; USD 45,000 - 65,000; Full time

Benefits offered by this job

Medical & dental insurance

Mental health support

Paid time off + holidays

100% vested 401(k)

Educational assistance

Job summary

WellSky is seeking a Reimbursement Coordinator for its Home Infusion team. The role focuses on reimbursement processes, claims submission, payment posting, and follow-up to ensure timely, accurate payments for WellSky clients. The ideal candidate has Medicare billing experience and familiarity with DME/POS reimbursement.

Responsibilities include QA of charges, claim status tracking, and managing denials and write-offs. Commitment to accuracy and adherence to security policies is essential.

Qualifications

• GED or High School Diploma.
• 1–2 years of relevant work experience.
• Experience with Medicare billing and collections.
• Knowledge of home infusion or DME/POS reimbursement.
• Working knowledge of Medicare LCDs and NCDs.

Responsibilities

• Obtain billing information from clients to generate claims and QA charges.
• Submit claims to insurance within timely filing periods and track status.
• Use reports to identify follow-up tasks and check claim status with payers.
• Research claim payments, partial payments and over-payments; escalate denials after 60 days.
• Perform collection follow-up on primary/secondary claims and patient balances.
• Prepare write-off forms when bad debt is identified and describe reasons.
• Perform other duties as assigned.

Skills

Medicare billing

Claims processing

Medical collections

Home infusion reimbursement

LCDs & NCDs knowledge

Education

GED or High School Diploma

Job description

The Reimbursement Coordinator is responsible for following the reimbursement process to ensure timely and accurate payment for products and services provided to patients on behalf of WellSky clients. The scope of this job includes overseeing claims processing, payment posting and follow-up activities, along with addressing discrepancies and resolving claims denials. This opening is for our Home Infusion team.

Key Responsibilities

• Obtain billing information from clients to generate claims, perform QA of charges, and make modifications or changes as required to produce a clean claim.
• Submit claims to insurance companies within the individual insurance company's timely filing period, prepare and/or print all secondary claims that do not automatically cross over from Medicare or other primary payer, and track pending claims.
• Utilize reports to determine tasks that require follow up and obtain claim's status by calling the payer and/or using an online claims status system.
• Research claim payments, partial payments and over-payments, and take appropriate action for escalating claims not paid within 60 days or for denied appeals.
• Perform collection follow up actions on primary and secondary claims as well as patient balances as assigned.
• Prepare write-off forms when bad debt is identified and document description of the reason for each write-off.
• Perform other job duties as assigned.

Required Qualifications

• GED or High School Diploma
• At least 1-2 years of relevant work experience
• Experience with Medicare billing and collections
• Knowledge of home infusion or DME/POS reimbursement
• Working knowledge of Medicare Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)

Job Expectations

• Willing to work additional or irregular hours as needed
• Must work in accordance with applicable security policies and procedures to safeguard company and client information
• Must be able to sit and view a computer screen for extended periods of time

Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky:

• Excellent medical with Rx, dental, and vision benefits
• Mental Health support through EAP
• Generous paid time off, plus 13 paid holidays
• 100% vested 401(K) retirement plans
• Educational assistance up to $2500 per year

WellSky is where independent thinking and collaboration come together to create an authentic culture. We thrive on innovation, inclusiveness, and cohesive perspectives. At WellSky you can make a difference.

WellSky provides equal employment opportunities to all people without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law.

WellSky is proud to be a drug-free workplace.

Applicants for U.S.-based positions with WellSky must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may be required to comply with applicable requirements, such as immunizations and occupational health mandates.

Data Privacy Notice for Job Applicants and Teammates

WellSky is a technology company leading the movement for intelligent, coordinated care worldwide. Our next-level software, analytics, and services power better outcomes and lower costs for stakeholders across the health and community care continuum. In today’s value-based care environment, WellSky helps providers, payers, health systems, and community organizations solve tough challenges, improve collaboration for growth, harness the power of data analytics, and achieve better outcomes by further connecting clinical and social care.