Remote Reimbursement & Appeals Specialist

OpenKrill; United States; Remote; USD 44.000 - 48.000; Vollzeit

Benefits dieser Stelle

Comprehensive benefits

Work-life balance

Zusammenfassung

PRO-spectus is seeking a Reimbursement Specialist II to ensure proper reimbursement for services, verify coverage, and submit claims. You will interact with insurers, patients, and providers while staying current on policy changes that affect billing and reimbursement.

Responsibilities include pursuing accounts receivable, handling appeals, and ensuring timely cash flow. The role emphasizes strong communication, organization, and adherence to evolving regulatory guidelines in a remote-friendly

Qualifikationen

• Experience with payors and clinical guidelines or medical policy is preferred.
• Conversant with medical and billing terminology.
• Expertise and knowledge of third-party payors.
• Computer and database management skills to efficiently manage proprietary electronic systems.
• Interpersonal and communication skills to deal with physicians, hospital leaders, nursing staff, patients, and family members.
• High School Diploma with 5+ years’ healthcare experience or an Associate's Degree in a healthcare-related field with 3+ years’ experience.

Aufgaben

• Ensure timely collection of outstanding Accounts Receivable and resolution of billing/claims issues.
• Research, evaluate, and interpret complex information relative to appeals and payor specific billing policies.
• Manage assigned accounts to ensure timely actions for positive cash flow.
• Stay up to date with changes in insurance policies and regulations affecting reimbursement procedures.

Kenntnisse

Billing & reimbursement knowledge

Communication skills

Organization & multitasking

Problem solving

Attention to detail

Remote collaboration

Ausbildung

High School Diploma with 5+ years healthcare experience

Associate's Degree in healthcare-related field

Tools

Proprietary EHR systems

Jobbeschreibung

PRO-spectus is seeking a Reimbursement Specialist II to ensure proper reimbursement for services, verify coverage, and submit claims. You will interact with insurers, patients, and providers while staying current on policy changes that affect billing and reimbursement.

Responsibilities include pursuing accounts receivable, handling appeals, and ensuring timely cash flow. The role emphasizes strong communication, organization, and adherence to evolving regulatory guidelines in a remote-friendly