Reimbursement Specialist: Patient Accounts & Claims

Zvh; Houston (TX); On-site; USD 60,000 - 90,000; Full time

Job summary

Baxter in Houston, TX is seeking a detail-oriented Reimbursement Specialist to optimize patient account reintegration into the reimbursement cycle. You will customize authorization workflows, verify coverage, and coordinate with payers to accelerate claim adjudication.

Join a team dedicated to improving access to care and ensuring accurate demographics and benefits data, ultimately reducing claim delays and supporting patients through complex billing processes.

Responsibilities

• Develop a flawless strategy to reintegrate patient accounts into the reimbursement process, either through acquiring prior authorization, performing change of insurance, or securing payment on claims.
• Perform detailed research on patient accounts within our "Error processing" process to identify gaps hindering reimbursement and offer a comprehensive summary for resolution.
• Apply outstanding investigational tools to find patient contact information, including classified and confidential databases.
• Ensure the accuracy of patient demographics and benefit information on file to minimize claim submission errors.
• Process claims promptly, identifying and resolving issues causing delayed processing and adjudication.
• Identify payer trends and implement payer-specific strategies to overcome reimbursement challenges.
• Review revenue reports like "claim validation" and "return billing report" to ensure reimbursement procedures are followed.
• Contact patients, families, and caregivers as needed to acquire current demographics, insurance, physician, and device usage information to ensure appropriate insurance reimbursement.
• Ensure timely follow-up and completion of errors received and authorizations initiated.

Job description

Baxter in Houston, TX is seeking a detail-oriented Reimbursement Specialist to optimize patient account reintegration into the reimbursement cycle. You will customize authorization workflows, verify coverage, and coordinate with payers to accelerate claim adjudication.

Join a team dedicated to improving access to care and ensuring accurate demographics and benefits data, ultimately reducing claim delays and supporting patients through complex billing processes.