Reimbursement Specialist

Tandem Diabetes Care

4d•$23 - $25•Remote

About The Position

Tandem Diabetes Care creates new possibilities for people living with diabetes, their loved ones, and their healthcare providers through a positively different experience. The primary responsibility of our Reimbursement Specialist is to assure all insurance claims are processed timely, accurately, and efficiently. The Reimbursement Specialist is responsible to secure payments from both contracted and non-contracted insurance entities as well as customers. This position will work closely with our Customer Sales Support to assure data accuracy as well as communicating requirements from health insurance plans.

Requirements

BA/BS or equivalent combination of education and applicable job experience.
2+ years of experience in medical billing or equivalent experience.
Experience in a HIPAA controlled environment is required.
Understanding of medical billing, insurance claim processing, and follow up procedures.
Understanding of all data required on a Health Care Financing Administration (HCFA) 1500 billing form.
Knowledge of billing codes and modifiers assigned by the Centers for Medicare and Medicaid Services (CMS).
Ability to understand Explanation of Benefits provided by heath care providers.
Knowledge of claims clearing houses and the basic functionality of these services.
Demonstrated ability to effectively communicate over the phone with customers and insurance companies to resolve clear-cut issues and answer questions according to department protocols and requirements.
Able to effectively share information related to work product in verbal and written form.
Able to contribute to the team by supporting the acceptance of new team members.
Demonstrated ability to work accurately, to follow instructions and schedules, and handle multiple priorities.
Experience with MS Office suite (Word, Excel, and Outlook), Internet, & customer relationship management systems (CRM).
Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.

Nice To Haves

Experience billing durable medical equipment is preferred.
Experience in diabetes or other disease management device/diagnostics is preferred.

Responsibilities

Reviews medical criteria to assure patient documentation meets standards.
Carefully reviews all patient related data and documentation for accuracy prior to claim submission.
Creates and submits healthcare claims to insurance companies.
Communicates with patients to advise on status of insurance claims, as necessary.
Contacts patients regarding collection of outstanding invoices.
Fields inbound calls from patients regarding inquiries related to insurance claims.
Makes outbound investigational calls to insurance providers to determine status of outstanding claims.
Negotiates structured payment plans.
Accesses CRM to receive and provide up to date patient claim information.
Keeps up to date with specifications on all of Tandem products and services.
Confirms completion of required training plan before assuming job responsibilities.
Ensures work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements.