Remote Insurance Reimbursement Specialist II

Spectraforce Technologies, Inc.; Cambridge (MA); Remote; USD 30,000 - 47,000; Full time

Job summary

Spectraforce Technologies, Inc. is seeking a Documentation Specialist II (Administrative) to verify insurance coverage and benefits, and to maintain accurate case documentation in the CRM from a 100% remote setting.

The role emphasizes handling sensitive patient data, coordinating with providers and Case Management, and ensuring timely, accurate information to support patient care and approvals under HIPAA guidelines.

Qualifications

• AA Degree required; Bachelor's degree preferred.
• Experience with health insurance reimbursement or relevant work preferred.
• Ability to handle sensitive information (PII/PHI) with discretion.
• Strong communication, problem-solving, and negotiation skills.
• Ability to work in a fast-paced environment with high-volume tasks.

Responsibilities

• Verify insurance coverage and benefits, contacting providers as needed.
• Research prior authorization processes and share requirements with Case Management.
• Follow up with payers on authorization status for enrolled patients.
• Re-verify benefits and address denials and barriers to continued treatment.
• Document interactions and data in the CRM with HIPAA compliance.
• Coordinate with Reimbursement Support to distribute tasks efficiently.
• Maintain up-to-date knowledge of billing, coding, and payer trends.
• Provide quality phone support to inbound callers.
• Assist in resolution of copay claim issues under Copay Assistance.

Skills

Communication

Problem-solving

Negotiation

Attention to detail

Education

AA Degree

Bachelor's Degree

Tools

Salesforce CRM

MS Word

MS Excel

MS PowerPoint

Job description

Spectraforce Technologies, Inc. is seeking a Documentation Specialist II (Administrative) to verify insurance coverage and benefits, and to maintain accurate case documentation in the CRM from a 100% remote setting.

The role emphasizes handling sensitive patient data, coordinating with providers and Case Management, and ensuring timely, accurate information to support patient care and approvals under HIPAA guidelines.