Remote Reimbursement Specialist I

Lumicera; Madison (WI); Vor Ort; USD 42.000 - 62.000; Vollzeit

Benefits dieser Stelle

Health, Dental, Vision insurance

Paid time off

Parental leave

401K with company match

Adoption Assistance

Flexible Spending Account

Educational assistance

Referral bonus up to $750

Zusammenfassung

Lumicera Health Services is seeking a Reimbursement Specialist I to join our team in Madison, WI. You will monitor claims for accuracy, ensure patient billing data is correct in the pharmacy system, and support reimbursement activities across the team.

Responsibilities include handling questions, assisting in claim resolution, and maintaining thorough documentation. A background in pharmacy billing and HIPAA compliance is preferred.

Qualifikationen

• Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing.
• Ability to interact cooperatively with others and maintain professional conduct.
• Understanding of HIPAA and compliance programs is preferred.
• Strong documentation and reference information upkeep in patient profiles.

Aufgaben

• Monitor claims activity for accuracy and successful submission.
• Ensure patient billing information is correctly set up in pharmacy software.
• Participate in conferences and meetings related to reimbursement and billing.
• Respond to questions or complaints regarding reimbursement and/or billing.
• Collaborate with internal teams to review and resolve claim issues.
• Maintain accurate reimbursement reference information and copay assistance data.
• Document information, insurance, and prescriptions/orders in patient profiles.
• Adhere to all applicable laws and internal ethical standards.
• Perform additional duties as assigned.

Kenntnisse

Claims billing experience

Pharmacy payer knowledge

Customer service

Compliance awareness

Team collaboration

Ausbildung

High School Diploma or GED

Some college preferred

Pharmacy technician license or trainee license preferred

CPhT preferred

Jobbeschreibung

Lumicera Health Services is seeking a Reimbursement Specialist I to join our team in Madison, WI. You will monitor claims for accuracy, ensure patient billing data is correct in the pharmacy system, and support reimbursement activities across the team.

Responsibilities include handling questions, assisting in claim resolution, and maintaining thorough documentation. A background in pharmacy billing and HIPAA compliance is preferred.