Reimbursement Specialist

Soleo Health•Chesterfield, MO

7d•Hybrid

About The Position

Soleo Health is seeking a Hybrid Reimbursement Specialist to support our Chesterfield, MO Specialty Infusion Pharmacy . Join us in Simplifying Complex Care! This position is hybrid, with working onsite Tuesdays, Wednesdays, and Thursdays. The Reimbursement Specialist will effectively perform the billing and collection activities necessary to facilitate the payment for the services provided. Soleo Health is an innovative national provider of complex specialty pharmacy and infusion services, administered in the home or at alternate sites of care. Our goal is to attract and retain the best and brightest as our employees are our greatest asset. Experience the Soleo Health Difference! Soleo’s Core Values: Improve patients’ lives every day Be passionate in everything you do Encourage unlimited ideas and creative thinking Make decisions as if you own the company Do the right thing Have fun! Soleo Health is committed to diversity, equity, and inclusion. We recognize that establishing and maintaining a diverse, equitable, and inclusive workplace is the foundation of business success and innovation. We are dedicated to hiring diverse talent and to ensuring that everyone is treated with respect and provided an equal opportunity to thrive. Our commitment to these values is evidenced by our diverse executive team, policies, and workplace culture. Soleo Health is an Equal Opportunity Employer, celebrating diversity and committed to creating an inclusive environment for all employees.? Soleo Health does not discriminate in employment on the basis of race, color, religion, sex, pregnancy, gender identity, national origin, political affiliation, sexual orientation, marital status, disability, genetic information, age, membership in an organization, parental status, military service or other non-merit factor.

Requirements

Required to work onsite Tues, Wed and Thurs of each week
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

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/explanation of benefits (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.