Reimbursement Specialist

PromptCare Companies • Madisonville, LA

2d • Remote

About The Position

PromptCare is seeking a motivated, experienced, and detail-oriented Reimbursement Specialist to handle patient billing and collections in the homecare infusion industry. The role requires proficiency in insurance data collection, verification, and authorization, as well as accurate documentation and computer entry for new referrals and patient admissions from start to finish in accordance with company policies and procedures. The position is remote, non-exempt, full-time, and scheduled for 40 hours per week, Monday through Friday. It reports to a Departmental Lead, Supervisor, or Manager.

Requirements

• High school diploma or equivalent.
• Working knowledge of insurance plans, including Medicare and Medicaid.
• Ability to perform patient billing and collections and insurance data collection, verification, and authorization.
• Ability to document and enter computer information for new referrals and patient admissions accurately and in accordance with company policies and procedures.
• Attention to detail and ability to work in a fast-paced environment.

Nice To Haves

• Two to three years of experience in electronic claims submission and medical collections.
• Industry experience with billing and collections in DME, home infusion, and/or enteral care.
• Accounts receivable and accounting experience.
• Knowledge of CPR+ and/or Caretend software.
• Experience in infusion reimbursement.

Responsibilities

• Collect third-party payor accounts for assigned payers.
• Follow up on reimbursement-related revenue cycle matters, including projects, issue escalation, denial management, and research.
• Maintain and update shared documentation about insurance plan policies, rules, and limitations to support the Intake Team.
• Identify adjustments, payment trends, and denials, and escalate problems as needed.
• Maintain confidentiality in all aspects of patient care, employee activities, and the office environment.
• Communicate changes regularly or as needed.
• Collaborate with other department staff, such as Intake and Reauthorization Specialists, to ensure timely collections.
• Assist the PBM and Billing Specialist with issues, billing backlogs, and end-of-month processes.
• Field and troubleshoot patient calls regarding benefits, claims, and balances.
• Proactively seek resolutions to billing issues.
• Complete CPR+/Caretend-related transactions accurately and in a timely manner.
• Perform other duties as assigned.

Benefits

• Comprehensive medical, dental, and vision package.
• 401(k) plan with company match.
• Vacation, sick time, personal days, and paid holidays.
• Life insurance with optional enhancements.
• Employee assistance program with free counseling and coaching sessions.
• Emotional well-being and work-life balance resources.
• Company-paid short- and long-term disability coverage with optional supplements.
• Accidental death and dismemberment insurance.
• Flexible spending account (FSA) and health savings account (HSA).
• Commuter spending programs.
• Volunteer and engagement opportunities.
• Employee referral bonuses.
• Exclusive discounts on entertainment, travel, and supplemental and cellphone plans.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED