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Reimbursement Specialist *Four Positions*
- Portsmouth, NH, USA
- Full Time
The Reimbursement Specialist is responsible for managing core reimbursement processes to confirm medical necessity and accurate pricing, and obtaining accurate payments to minimize the financial burden for patients. This position will be responsible for collaborating with and supporting the other Revenue Operations functional teams. This is a full-time, non-exempt position reporting to the Senior Manager of Billing Operations and is based in Portsmouth, NH.
Essential Duties & Responsibilities:
Complete insurance benefit verifications to confirm active coverage
Consistently follow-up on outstanding insurance balances via phone and insurance website in a timely manner
Investigate and resolve all incorrect payments and escalate trended changes in behavior as identified
Submit and track the status of claim appeals for payment disputes
Verify presence of and accuracy of prior authorizations and pricing agreements for all patients with insurance
Identify and escalate contracting implementation challenges and opportunities
Build and maintain relationships with key personnel within health insurance organizations to effectively process patient accounts
Perform all other duties or priorities assigned by management as needed
Bachelors degree or equivalent experienece preferred
0-3 years experience in a reimbursement-related function, DME-specific experience preferred
Familiarity with medical policies and payer contracts preferred
Familiarity with basic medical and insurance terminology preferred
Familiarity with Microsoft Office and SAP preferred
Knowledge, Skills, and Behaviors:
Strong written and verbal communication skills with internal and external customers
Strong customer service skills
Maintain integrity and tenacity while working accounts
Ability to understand and escalate difficult situations
Ability to collaborate with key internal and external teams
Ability to solve problems and set priorities
Ability to work independently with minimal supervision
Ability to work efficiently and cooperatively in a fast-paced office setting
Ability to lift 20 pounds
Patient-forward: aspiring to make a difference in cancer.
Our patient-forward mission
Together with our patients, we strive to extend survival in some of the most aggressive forms of cancer by developing and commercializing our innovative therapy.
Our patient-forward values