Reimbursement Specialist

Palmetto Infusion Careers•Eastman, GA

1d•Onsite

About The Position

This position is responsible for submitting invoices, applying payments, and following up on outstanding balances to ensure accurate and timely reimbursement. Additional duties include tracking authorizations and maintaining medical records.

Requirements

Prior medical billing experience
High school diploma or equivalent
Proficient at partner programs (i.e.: MS Outlook, Word, Excel).
Ability to cope with ambiguous, changing environment while under pressure in a calm manner.
Must be able to work as a team member and develop productive and cooperative working relationships with all members of the Palmetto Infusion team.
Uphold the confidentiality of protected health information and follow all HIPAA policies.
Access to sensitive information and a breach of information may be grounds for immediate termination.

Responsibilities

Understand the terms and fee schedule for all contracts for which invoices are submitted.
Correctly determine quantities and prices for drugs billed.
Verify that the services and products are correctly authorized, and that required documentation is on file.
Evaluate all completed prescriptions/authorizations to ensure that the appropriate information has been obtained and documented on appropriate insurance forms for reimbursement and compliance.
Update insurance carriers when a change has occurred and obtain revised and/or new patient authorizations.
Perform outbound calls to patients, physicians and insurance companies to identify and gather insurance information, follow up on patient paperwork and authorizations, and update claims status.
Verify that payments received are correct according to the fee schedule.
Review the payments applied to the patient account to ensure applied correctly.
Ensure that secondary bills are mailed within 48 hours of receipt of payment.
Notify the Reimbursement Supervisor if there are overpayments and/or duplicate payments for the same service by submitting a refund request.