Reimbursement Coordinator - Home Infusion

WellSky; United States; On-site; USD 45,000 - 65,000; Full time

Benefits offered by this job

Excellent medical benefits

Mental Health support

Paid time off

13 paid holidays

401(k) retirement plan

Educational assistance

Job summary

WellSky is seeking a Reimbursement Coordinator for our Home Infusion team to ensure timely and accurate payment for products and services provided to patients through WellSky clients. You will manage the reimbursement lifecycle, including claims submission, QA of charges, and follow-up with payers to resolve denials and discrepancies, ensuring clean claims and prompt payment.

Knowledge of Medicare billing, LCDs/NCDs, and DME/POS reimbursement is required, with a strong focus on compliance and

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 Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)

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.

Skills

Medicare billing & collections

Home infusion reimbursement

LCDs and 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. We invite you to apply today and join us in shaping the future of healthcare!

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

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.

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 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.

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