Remote Reimbursement Specialist I — Copay & Claims

Lumicera; Springfield (IL); Vor Ort; USD 42.000 - 65.000; Vollzeit

Benefits dieser Stelle

Health insurance

Dental insurance

Vision insurance

401K

Zusammenfassung

Lumicera Health Services seeks a Reimbursement Specialist I to support copay assistance reimbursements and billing processes under supervision by the Assoc. Manager, Specialty Pharmacy Services, and Team Lead.

The role emphasizes accurate claim submissions and maintaining patient billing data. Responsibilities include monitoring claims activity, assisting in billing inquiries, coordinating with internal teams, and documenting information in patient profiles while upholding regulatory and ethical

Qualifikationen

• Experience with pharmacy, health plan or clinical insurance claims billing, benefit assessments, billing/claims documentation, or claims auditing is preferred.
• The ability to consistently interact cooperatively and respectfully with other employees

Aufgaben

• Ongoing monitoring of claims activity for accuracy and successful submission.
• Ensures that patient billing information is set up appropriately in the pharmacy software.
• Participates in conferences and meetings related to reimbursement/billing.
• Responds to employee/patient/client questions or complaints regarding reimbursement and/or billing.
• Works with internal teams to review and resolve claim issues.
• Maintains accurate reference information relating to reimbursement and copay assistance.
• Documents information, insurance and prescriptions/orders within the patient profile accurately.
• Complies with all applicable laws and maintains high ethical standards.

Jobbeschreibung

Lumicera Health Services seeks a Reimbursement Specialist I to support copay assistance reimbursements and billing processes under supervision by the Assoc. Manager, Specialty Pharmacy Services, and Team Lead.

The role emphasizes accurate claim submissions and maintaining patient billing data. Responsibilities include monitoring claims activity, assisting in billing inquiries, coordinating with internal teams, and documenting information in patient profiles while upholding regulatory and ethical