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Job Description
- Req#: 1169
- Prepares and reviews insurance claims prior to billing.
- Submits claims to insurance carriers through clearing house, fax, mail, or website.
- Manages the status of accounts and balances and identifies inconsistencies.
- Follows up on unpaid claims within company policy timeframe.
- Creates and submits appeals for denied claims.
- Assists clients and staff with referral questions when needed.
- Posts payments to the patient's accounts as they are received from insurance and patients.
- Identifies any potential overpayments and underpayments and submits refund requests as needed.
- Sends statements to patients.
- Requests adjustments as needed.
- Resolves patient issues and complaints concerning billing.
- Submits regular reports on the status of unpaid accounts.
- Other duties as assigned
- Takes personal responsibility for the quality and timeliness of work and achieves results with little oversight.
- Diligently attends to details and pursues quality in accomplishing tasks.
- Builds and maintains customer satisfaction with the products and services offered by the organization; provides excellent service to internal and external customers.
- Understands and learns from what others say.
- Identifies, collects, and organizes data for analysis and decision-making.
- Adapting to and working with a variety of situations, individuals, and groups. Openness to different and new ways of doing things; willingness to modify one's preferred way of doing things.
Reimbursement Specialist - Join Our Healthcare Team!
FLSA Status: Non-exempt
Reports To: Collections Manager
Are you a detail-oriented professional with experience in insurance claims, reimbursement processing, and billing accuracy? At FlexCare, we are looking for a skilled Reimbursement Specialist to ensure timely and accurate processing of insurance claims and payments. If you have strong analytical skills and a background in healthcare reimbursement, we'd love to hear from you!
Why You'll Love Working Here:
• Work alongside a passionate and supportive team
• Impact lives daily through exceptional patient care
• Grow and advance with continued learning opportunities
• Enjoy a healthy work-life balance
What You'll Do:
The Reimbursement Specialist is responsible for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims.
To perform this job successfully, an individual must be able to perform each essential duty listed below satisfactorily. Reasonable accommodation may be made to enable qualified individuals with disabilities to perform essential functions.
Your key responsibilities include:
Competency Statements:
What You Need to Succeed:
• Education: High school diploma or equivalent.
• Experience: At least 2 years' experience in infusion therapy or related healthcare services. Experience working with healthcare insurance and Customer Service.
• Soft Skills: Attention to detail, problem-solving, and customer service mindset.
*Additional Eligibility Qualifications
Must be able to accomplish any and all duties with little to no assistance.
Position Type and Expected Hours of Work
This is a full-time position
Hours: Monday-Friday, 8:00 AM - 5:00 PM (schedule may adjust based on business needs).
Work Environment & Physical Requirements:
This role operates in an office setting, requiring frequent standing, walking, reaching, and lifting. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
What We Offer - Full-Time Benefits/Perks:
We take care of you with company-sponsored health, dental, and vision insurance, plus short-term disability.
Long-term disability coverage, and Group Term Life insurance a financial security for you and your Family
Birthday Off - Celebrate your special day with a paid day off just for you!
Parental Leave - Paid time off for new parents to bond with their little one.
Secure your financial future with our 401(k) retirement plan.
Wellness Perks - Stay healthy and supported with our wellness benefits.
Enjoy paid time off, company holidays, and a 24-hour floating holiday to use whenever you need.
Join Our Team and Make a Difference!
At FlexCare, we believe in empowering our employees and delivering exceptional patient care. If you're ready to take your career to new heights, apply today and be part of a dynamic, patient-focused team!
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