Reimbursement Specialist

Soleo Health Inc • Town of Mount Pleasant, NY

1d • Remote

About The Position

Soleo Health is seeking a Reimbursement Specialist to support our Specialty Infusion Pharmacy and work Remotely (USA). Join us in Simplifying Complex Care!

Specialty infusion reimbursement experience required.

The Reimbursement Specialist will effectively perform the billing and collection activities necessary to facilitate the payment for the services provided. Responsibilities include:

Requirements

• Knowledge of home infusion therapy billing practices required
• Knowledge of HCPC coding and medical terminology
• Excellent math and writing skills
• Experience providing customer service to internal and external customers
• Excel and Outlook experience required
• High School Diploma or GED required

Nice To Haves

• CPR+ systems experience preferred

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.

Benefits

• Competitive Wages
• 401(k) with a Match
• Referral Bonus
• Paid Time Off
• Great Company Culture
• Annual Merit Based Increases
• No Weekends or Holidays
• Paid Parental Leave Options
• Affordable Medical, Dental, & Vision Insurance Plans
• Company Paid Disability & Basic Life Insurance
• HSA & FSA (including dependent care) Options
• Education Assistance Program

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 251-500 employees