Reimbursement Specialist

Job Description

Job Description

Reimbursement Specialist

Position Type : Full-time, Remote (with potential in-office meetings)

Location : Remote, with occasional in-office meetings

Work Hours : Monday through Friday, 8 : 00 AM - 5 : 00 PM

Salary : $18 - $20 per hour (depending on experience)

Job Summary : We are seeking a detail-oriented and highly motivated Reimbursement Specialist to join our team. This role is primarily remote, with the option to attend in-office meetings as needed. The successful candidate will be responsible for reviewing and submitting authorization requests to Medicaid and the Department of Mental Health (DMH), correcting authorization errors, and addressing any issues that may prevent services from billing out correctly.

Key Responsibilities :

Review and submit authorization requests to Medicaid and DMH.

Identify and correct authorization errors to ensure accurate billing.

Work daily reports to identify and resolve billing issues.

Communicate effectively with internal teams to resolve discrepancies.

Maintain accurate records and documentation of all authorization requests and corrections.

Monitor and update the status of authorizations and billing processes.

Assist in improving processes for efficient billing operations.

Requirements :

Strong attention to detail with the ability to multitask.

Proficient in Microsoft Excel (Intermediate / Advanced level preferred).

Strong communication skills, both written and verbal.

Ability to work independently and manage tasks efficiently.

Familiarity with the Oklahoma Medicaid website is preferred.

Typing speed of 45+ words per minute (Typing test score requested prior to interview).

Ability to adapt to a remote work environment, with occasional in-office attendance for meetings.

Qualifications :

Prior experience working with Medicaid and DMH authorization requests.

Experience in billing or reimbursement processes.

Knowledge of medical terminology and healthcare procedures.

Additional Information :

This position adheres to a Drug-Free Workplace policy. Possession of a medical marijuana license does not exempt employees from drug testing, and testing positive for marijuana could result in the revocation of a job offer or dismissal from employment.

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HS Diploma or Equivalent; 1-2 years of Medical Reimbursement Experience

• Compile, compute, and record billing, accounting, statistical, and other numerical data for billing purposes. Prepare billing invoices for services rendered or for delivery or shipment of goods.
• Verify accuracy of billing data and revise any errors.
• Resolve discrepancies in accounting records.
• Prepare itemized statements, bills, or invoices and record amounts due for items purchased or services rendered.
• Operate typing, adding, calculating, or billing machines.
• Post stop-payment notices to prevent payment of protested checks.
• Verify signatures and required information on checks.
• Keep records of invoices and support documents.
• Perform bookkeeping work, including posting data or keeping other records concerning costs of goods or services or the shipment of goods.
• Contact customers to obtain or relay account information.
• Route statements for mailing or over-the-counter delivery to customers.
• Monitor equipment to ensure proper operation.
• Fix minor problems, such as equipment jams, and notify repair personnel of major equipment problems.
• Review documents, such as purchase orders, sales tickets, charge slips, or hospital records, to compute fees or charges due.
• Track accumulated hours and dollar amounts charged to each client job to calculate client fees for professional services, such as legal or accounting services.
• Weigh envelopes containing statements to determine correct postage and affix postage, using stamps or metering equipment.
• Consult sources, such as rate books, manuals, or insurance company representatives, to determine specific charges or information such as rules, regulations, or government tax and tariff information.
• Compare previously prepared bank statements with canceled checks and reconcile discrepancies.
• Match statements with batches of canceled checks by account numbers.
• Take orders for imprinted checks.
• Encode and cancel checks, using bank machines.
• Load machines with statements, cancelled checks, or envelopes to prepare statements for distribution to customers or stuff envelopes by hand.
• Perform general administrative tasks, such as answering telephones, scheduling appointments, and ordering supplies or equipment.
• Create billing documents, shipping labels, credit memorandums, or credit forms.
• Compile reports of cost factors, such as labor, production, storage, and equipment.
• Answer inquiries regarding rates, routing, or procedures.
• Review compiled data on operating costs and revenues to set rates.
• Estimate market value of products or services.
• Update manuals when rates, rules, or regulations are amended.
• Compute credit terms, discounts, shipment charges, or rates for goods or services to complete billing documents.