Reimbursement Coordinator - Home Infusion

The Reimbursement Coordinator generates and collects Home Infusion and Durable Medical Equipment (DME) claims for submissions to patients and / or third-party payers.

These claims result from products and services delivered to or administered to patients on behalf of our clients. The Reimbursement Coordinator also performs collection follow up on primary and secondary claims as well as patient balances as assigned using the techniques outlined in the Guidelines for Success’ document.

You will be responsible for the following :

Obtaining billing information from Clients and generating daily claims

Performing Q.A. of charges received from Clients and making modifications / changes as required to produce a clean claim

Reviewing contract / details of new payers before billing. Working with supervisor / manager on changes needed in the billing system (e.g., CPR+, CareTend)

Tracking pending claims

Submitting claims to insurance companies in a timely fashion and within the individual insurance company’s timely filing period.

Preparing and / or printing all secondary claims that do not automatically cross over from Medicare or other primary payer

Following up on patient balances within established timeframes.

Obtaining claim’s status by calling the payer and / or using an online payer portal

Utilizing reports to determine tasks that require follow up

Taking appropriate action for escalating claims not paid within 60 days or for denied appeals

Preparing write-off request when bad debt is identified. Documenting description of the reason for the write-off.

Researching claim payments, partial payments, over payments.

Prioritizing claims to identify Top Ten high balance accounts. Keeping accounts current until complete. Preparing report of Top Ten accounts monthly for supervisor / manager review.

Preparing status report with supporting documentation of all claims over 90 / 120 days

Required Qualifications :

1-2 years of billing and / or collections or insurance claims processing

Preferred Qualifications :

Healthcare insurance claims processing knowledge

Healthcare billing and collections knowledge

Working knowledge of word and excel

Home infusion and durable medical equipment billing and collection experience preferred, IV field experience, medical billing certification, some college education

LI-KL2

LI-Remote

Additional job expectations applicable to this position include :

• Willingness to work additional or irregular hours as needed
• Working in accordance with corporate and organizational security policies and procedures
• Performing other responsibilities as assigned

Here are some of the exciting benefits full-time teammates are eligible to receive at WellSky :

• Excellent medical, dental, and vision benefits
• Mental health benefits through TelaDoc
• Prescription drug coverage
• Generous paid time off, plus 13 paid holidays
• Paid parental leave
• 100% vested 401(K) retirement plans
• Educational assistance up to $2500 per year
30+ days ago