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PromptCare · 1 day ago

Reimbursement Specialist

New Providence, NJ

Full-time

Hybrid

Entry, Mid Level

2+ years exp

PromptCare is a healthcare company seeking a highly motivated and detail-oriented Reimbursement Specialist to join their AR Infusion team. The role involves managing patient billing and collections, ensuring compliance with insurance data collection, verification, and authorization processes.

Health CareHome Health CareInsuranceMedicalPharmaceuticalTherapeutics

Responsibilities

Collections of third-party payor accounts for assigned payers

Ensure proper follow-up is performed on all aspects of the revenue cycle related to reimbursement, including projects, problem and issues escalation, denials management and research

Maintain and update shared documentation to assist Intake Team with the various policies, rules and limitations for insurance plans

Identify adjustments, payment trends and denials and ensure problems are escalated as necessary

Maintain confidentiality in all aspects of patient care, employee activities and office environment

Communicate changes regularly or as often as needed

Work collaboratively with other department staff such as Intake & Reauthorization Specialist to ensure timely collections

Assist the PBM and Billing Specialist with issues, billing backlogs and end-of-month processes

Field and troubleshoot calls from patients regarding benefit, claims and patient balances

Pro-actively seek resolutions to any billing issues that may arise

Perform CPR+/Caretend related transactions accurately and timely

Perform other duties as assigned

Qualification

Infusion reimbursementElectronic claims submissionInsurance plans knowledgeBilling/collections experienceCPR+ softwareCaretend softwareAccounts receivable experienceDetail-orientedCommunication skills