Reimbursement Specialist
$23 - $27
Apply now (opens in a new tab)Reimbursement Specialist
L5
$23 - $27
Occupations
Billing and Posting ClerksBookkeeping, Accounting, and Auditing ClerksInsurance Claims and Policy Processing ClerksIndustries
All Other Miscellaneous Ambulatory Health Care ServicesPharmacy Benefit Management and Other Third Party Administration of Insurance and Pension FundsAll Other Outpatient Care Centers- Ensure accurate and timely billing and reimbursement by submitting clean claims to primary and secondary payers
- Review, correct, and resubmit rejected or denied claims promptly
- Verify insurance eligibility, authorizations, and documentation prior to medication delivery
- Maintain complete and accurate patient billing files, including CMNs, prescriptions, and supporting medical documentation
- Confirm delivery dates before claim submission and invoice patients for applicable responsibility amounts
- Serve as a key partner to pharmacy, care coordination, and field staff to resolve billing issues
- Track accounts receivable activity and maintain detailed AR status reporting
- Communicate regularly with insurance companies, providers, and internal teams regarding claim status
- Predict cash flow based on claim progression and payer response patterns
- Maintain documentation of all payer communications and follow?ups
- Respond to payer requests for records, authorizations, and clinical documentation in a timely manner
- Support insurance contract maintenance and payer audits as needed
- Monitor trends in payer behavior, coverage changes, and industry updates, escalating concerns appropriately
- Participate in quality assurance activities, audits, training, and continuing education initiatives
- Bring reliability, organization, and follow?through to a fast?paced revenue cycle environment
- Deep care about how billing accuracy impacts patient access and experience
- At least two years of medical insurance or reimbursement experience
- Strong attention to detail and the ability to manage multiple priorities
- Clear verbal and written communication skills
- Comfort working with billing systems, payer portals, and Microsoft Office tools
- Strong customer service mindset and professionalism when resolving complex payer issues
- Ability to stay organized and adaptable amid changing workloads
- Preferred (but not required):Home infusion or specialty pharmacy reimbursement experience
- Familiarity with CPR+ and/or CareTend systems
- Certified Pharmacy Technician credentials
- Experience supporting patients with chronic or rare conditions
Level
SeniorL5
Salary
$23 - $27
Location
Overland Park, KS
Occupation
Billing and Posting Clerks
Industry
All Other Miscellaneous Ambulatory Health Care Services
Posted
6 days ago
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