Reimbursement Specialist - Healthcare

PhilipsPlymouth, MN
$24 - $36Hybrid

About The Position

Join the S&RC RespirTech team as a Reimbursement Specialist, where you'll manage insurance claim follow-up, resolve payment issues and denials, and help ensure timely reimbursement for respiratory care products and services. This is an office role at Philips, a health technology company.

Requirements

  • High school diploma or vocational education.
  • 2+ years of experience in Medical Billing and Invoicing, Accounts Receivable/Payable, Contract Management or equivalent.
  • Knowledge of insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield and commercial plans.
  • Experience managing medical claim denials, appeals, and recoupments.
  • Knowledge of insurance eligibility verification, benefits, and prior authorizations.
  • Must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this position.
  • Analytical and detail-oriented professional with strong problem-solving and communication skills.
  • Ability to thrive working independently in a fast-paced environment while maintaining a collaborative and adaptable team-focused mindset.
  • US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future.

Responsibilities

  • Follow up on outstanding insurance claims to secure accurate and timely payment from commercial, government, and private-pay accounts.
  • Monitor claim status and work to reduce aging accounts receivable.
  • Investigate, resolve, and respond to claim denials, unpaid claims, and payer correspondence.
  • Prepare and submit appeals within payer deadlines and requirements.
  • Review payment information, including Explanation of Benefits (EOBs) and Remittance Advice (RA), and process necessary adjustments, overpayments, and balance corrections.
  • Communicate and collaborate with insurance carriers and internal teams to resolve reimbursement issues, update insurance information, and support timely collections.
  • Maintain compliance with company policies, HIPAA requirements, and reimbursement procedures.
  • Support special projects, process improvements, and team training initiatives.

Benefits

  • Generous PTO
  • 401k (up to 7% match)
  • HSA (with company contribution)
  • Stock purchase plan
  • Education reimbursement
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