Jobs_at_Soleo_Health

REIMBURSEMENT SPECIALIST - Remote

Soleo Health is seeking a Reimbursement Specialist to work from home who can effectively perform the billing and collection activities necessary to facilitate the reimbursement process.

ESSENTIAL DUTIES AND RESPONSIBILITIES 

  • Responsible for the preparation of accurate medical and pharmacy claims for home infusion therapy services to various payers (e.g. commercial Rx Card Payers, Government Payers, Employer/ Institutional Payers, and Medical).
  • Creates and submits secondary medical claims in a timely manner;
  • Monitors billing requirements pursuant to contracts with third party payers or government programs.
  • Reviews payments/EOBs applied to invoice to ensure that correct payment has been received;
  • Addresses payer and electronic transmission rejections;
  • Researches claim denials and follows-up with payer for resolution;
  • Monitors payer correspondence and provides requested information, as appropriate;
  • Makes routine collection calls on outstanding claims;
  • Researches refund requests received by payers and prepares refund according to findings;
  • Documents notes in a clear and concise fashion in Company software system;
  • Identifies issues/trends and escalates to Manager when assistance is needed;
  • Provides exceptional Customer service to internal and external customers;
  • Ensures compliance with federal, state, and local governments, third party contracts, and company policies.

 

QUALIFICATION REQUIREMENTS

  • Knowledge of home infusion therapy billing practices, preferred;
  • Knowledge of HCPC coding and medical terminology;
  • Excellent math and writing skills
  • Experience providing customer service to internal and external customers
  • CPR+ systems experience preferred
  • Excel and Outlook experience required;
  • High School Diploma or GED required;

 

Apply now for this position