Reimbursement Specialist

Banner Health Corporate; Gilbert (AZ); Hybrid; USD 28,000 - 42,000; Full time

Job summary

Banner Health in Arizona seeks an Administrative Services professional to support home medical equipment reimbursement. You will obtain and maintain CMNs, orders, and other documents to ensure timely payer reimbursements.

As part of a coordinated team you will assist patient financial services, verify documentation, track orders, and prepare end-of-day reports while resolving overdue accounts. This remote role follows a daytime schedule between 7:00 AM and 5:00 PM Arizona time, and requires 2–3

Qualifications

• High school diploma or GED required.
• 2–3 years experience in patient accounts, pharmacy, or equipment intake.
• Knowledge of regulatory and accreditation requirements for medical equipment and infusion meds.
• Strong customer service and interpersonal skills.
• Good organizational and problem-solving abilities.
• Ability to maintain detailed records and use office software.

Responsibilities

• Obtain and maintain CMNs, physician orders, and other docs to ensure reimbursements.
• Attend in-service education on policy, procedure and ADR related material.
• Assist patient financial services with accurate charges and verify documentation.
• Schedule CMNs and orders, enter data into billing system for reimbursement.
• Research overdue accounts and follow up by mail/phone to resolve issues.
• Document appropriately and process adjustments for non-covered or denied services.

Skills

Customer service

Organizational skills

Communication

Computer literacy

Regulatory knowledge

Attention to detail

Education

High school diploma/GED

Tools

Office software

Job description

Department Name: Admin-HME Work Shift: Day Job Category: Administrative Services

Find your path in health care. We want to change the lives of those in our care – and the people who choose to take on this challenge. If you’re ready to change lives, we want to hear from you.

Ready to make your mark? Join Banner Health and help us deliver exceptional care — one document, one patient, one day at a time.

This is a remote position with work hours scheduled between 7:00 AM and 5:00 PM (Arizona time), depending on business needs.

POSITION SUMMARY

This position works as a member of a team to ensure reimbursement for services in a timely and accurate manner. Responsible for obtaining and maintaining all supporting documents required by government agencies and other insurance companies for appropriate reimbursement of home medical equipment. Provides administrative services and assistance. Coordinates processes for an assigned area such as but not limited to claims, transitions, loan closets, selection, validation or billing.

CORE FUNCTIONS

1. Obtains and maintains physician orders, authorizations, Certificates of Medical Necessity (CMN) and other supporting documents to ensure reimbursement from government agencies and insurance companies for medical equipment services.


2. Attends in-service education and training on policy, procedure, and work related material such as ADR (Medicare - Additional Documentation Request).


3. Acts as an internal resource for qualifying criteria, payment limitations and required documentation. Provides assistance to patient financial services regarding accurate patient account charges. Verifies the accuracy of required documentation. Examines and tracks all orders to ensure proper billing. Verify balances and receipts for all form of payments then completing an End of Day report.


4. Schedules and maintains CMNs and physician's orders for timely delivery and enters completed order into billing system for reimbursement.


5. Research/responds to overdue/delinquent accounts and follows up by mail and/or phone to resolve in a timely manner.


6. Research customer accounts thoroughly and documents appropriately, processes adjustments when services are non-covered or been denied.


7. This position is responsible for Certificates of Medical Necessity, physician orders and documentation for home medical equipment. The incumbent makes final independent decisions on the accuracy of the documentation.

MINIMUM QUALIFICATIONS

• High school diploma/GED or equivalent working knowledge.


• Skills and abilities normally gained with 2-3 years of experience in patient accounts, pharmacy or equipment intake.


• This position requires a thorough understanding of regulatory and accreditation requirements of medical equipment and infusion medications for government and third party agencies to ensure compliance and appropriate reimbursement.


• Requires effective interpersonal skills, with ability to provide effective customer service.


• Demonstrated organizational and problem solving skills are needed.


• Ability to keep detailed records regarding equipment and medical records.


• Ability to communicate effectively.


• Able to prioritize and organize daily work.


• Demonstrated ability to use and develop proficiency with computers and office software.

PREFERRED QUALIFICATIONS

• 1-2 years of experience in clerical, customer relations and/or customer service departments is preferred.


• Additional related education and/or experience preferred.

Estimated Pay Range: $20.41 - $30.61 / hour

Banner Health is committed to pay equity and transparency. The posted compensation range is a reasonable estimate that extends from the lowest to the highest pay Banner Health in good faith believes it might pay for this particular job, based on the circumstances at the time of posting. This range is based on possible base salaries and does not include the value of our total rewards package. Actual pay determined at offer will be based on years of relevant work experience, education, certifications, skills, and geographic location, along with a review of current employees in similar roles to ensure pay equity is achieved and maintained.

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Our organization supports a drug-free work environment.

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We are proud to offer a comprehensive benefit package for all benefit-eligible positions. Please visit our Benefits Guide for more information.

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