Prochant US

Role Description Prochant is looking for experienced and driven professionals to join our team as a Reimbursement Success Manager. This role plays a critical part in supporting the success of Prochant, a U.S.-based outsourced healthcare billing organization, by overseeing key operational and client-facing functions. The Reimbursement Success Manager is responsible for building and maintaining strong client relationships, including regular engagement with executive sponsors and key stakeholders. This role leads the strategic planning and execution of billing operations across multiple medical billing teams, with a focus on the DME, Sleep, and Infusion sectors. - Developing, implementing, and upholding standardized policies and procedures. - Optimizing billing workflows across a diverse client base and markets. - Maintaining consistent billing performance and cash flow. - Identifying opportunities to enhance collections. - Proactively recognizing risks that could impact reimbursement outcomes. - Prioritizing initiatives, guiding teams, and driving operational excellence. - Cultivating strong partnerships with clients. - Identifying growth opportunities within existing accounts. - Contributing to new business development efforts. - Collaborating with internal cross-functional teams, including operations and sales. Qualifications - Associate degree preferred. - 3–5 years of progressive experience in DME or Revenue Cycle Management. - Project management experience preferred. - Strong presentation skills with the ability to engage audiences of varying sizes. - Excellent written and verbal communication skills. - Proven ability to manage time effectively, multitask, and prioritize competing demands. - Proficiency in Microsoft Office applications (PowerPoint, Teams, Outlook, Excel). - Experience with at least one industry-standard billing system (e.g., Brightree, TIMS, HDMS, Niko). - Strong analytical and problem-solving capabilities. - Experience collaborating with global or international teams. - Familiarity with California payer HME/DME requirements preferred. - Capitation experience preferred. - Willingness to travel domestically and internationally preferred. Benefits - Excellent benefits package including: - Health Insurance. - Gap Insurance. - Dental Insurance. - Vision Insurance. - Short Term/Long Term Disability (company paid). - Term Life Insurance (company paid, employee can elect additional). - Disability Income. - Level Term Life. - Accident Insurance. - Critical Illness Insurance. - Floating holidays and paid time off. - 401K with Company match. - Family Teledoc Plan (Company Paid).

Role Description The DME Reimbursement Specialist is responsible for multiple areas that are key to success for Prochant, a billing service and process outsourcing company in the U.S. healthcare industry. The responsibilities include: - Billing Review - Claim Generation - A/R & Denial Management - Unaddressed Claim Management - Stop/Held Revenue review - Correspondence review and Indexing - Reporting and reconciliation of all executable work tasks - Escalations/tasking of work exceptions to appropriate parties - Management of follow-ups - Peer support/Peer coaching - Quality Assurance - Eligibility - Prior Authorization - Intake - Cash posting In this role, you are responsible for consistent productions of intake, billing, collections, and cash posting. This includes: - Billing Review & Claims Generation - Manage inbound queue of orders to be reviewed/claims to be generated - Quality review prior to claim generation - Claim generation within specified turnaround time - Maintenance of downloads and production logs - Exception Tasking - Follow Ups - Peer Coaching/Peer Support - Peer Quality Assurance (Audits) - A/R & Denial Management - Denied claim review and analysis - Denied claim resolution action including, but not limited to: - Telephone claim status requests - Telephone re-opening requests - Medical documentation/Supporting documentation reviews - Redeterminations and appeals - Fax - Mail - Online - Denied claim tasking to appropriate parties for follow up - Authorization team (internal or external) - Documentation team (internal or external) - Peer Coaching/Peer Support - Peer Quality Assurance (Audits) - Documentation Review & Indexing - Review of inbound scanned documentation - Analysis of documents and assignment to appropriate document classes (for follow up) - Production log maintenance - Peer Coaching/Peer Support - Peer Quality Assurance (Audits) - Patient and order generation (intake) - Eligibility or benefit verification - Prior authorization submission - Cash Posting Qualifications - High School diploma or GED - 2+ years DME / HME billing & collections experience - Experience managing intake, billing, collections, and cash posting - Knowledge of the HDMS billing system - Willingness to undergo additional identity verification through ID.me - Knowledge of one or more of the following additional DME / HME billing systems: Brightree, TIMS, Bonafide, or CPR+ preferred - California Insurance experience preferred Benefits PROCHANT OFFERS SOME OF THE BEST BENEFITS IN THE INDUSTRY! WE TAKE GREAT CARE OF OUR EMPLOYEES. FORTUNE-500 LEVEL BENEFITS PACKAGE. - Excellent benefits package including: - Health Insurance - Gap Insurance - Dental Insurance - Vision Insurance - Short Term / Long Term Disability (company paid) - Term Life Insurance (company paid, employee can elect additional) - Full suite of CHUBB supplemental insurance plans including: - Disability Income - Level Term Life - Accident Insurance - Critical Illness Insurance - Pre-Paid Legal - FSA / HSA with eligible plans - 401K with company match - Floating holidays and paid time off

Role Description The Lead Infusion Reimbursement Specialist is responsible for providing thought leadership, quality assurance, and advanced expertise in billing and collections within Prochant’s Infusion Division. In addition to managing reimbursement tasks, the lead infusion reimbursement specialist acts as a mentor and trainer for other reimbursement specialists, supporting their professional growth and development. Serving as a liaison between reimbursement specialists and the Reimbursement Manager, they help streamline operations, resolve challenges, and assist with complex projects. This position is crucial in fostering a collaborative, high-performing team environment while supporting the division’s strategic growth objectives. - Overseeing timely and accurate processing of infusion reimbursement claims, ensuring clean claim submission and follow-up with health plans. - Utilizing billing software, payer portals, and data reporting tools to manage outstanding A/R and enhance cash collections. - Mentoring and training reimbursement specialists, providing guidance on best practices and strategies for resolving billing challenges. - Acting as a liaison between team members and management, assisting with escalated client concerns, and freeing up manager time. - Conducting quality assurance checks to ensure claim accuracy, compliance, and efficiency in reimbursement processes. - Proactively identifying potential roadblocks affecting clients or Prochant, escalating or resolving them in a timely manner. - Maintaining strong relationships with clients, responding to inquiries with professionalism and clarity. - Prioritizing responsibilities, managing workload effectively, and adapting to changing priorities while maintaining focus on deadlines. - Collaborating with offshore teams and participating in efforts to support organizational needs. Qualifications - High School diploma or equivalent required. - Minimum 2 years of experience in home infusion billing and collections. - Experience using Brightree, CPR+, CareTend, or WeInfuse software preferred. - Strong written and verbal communication skills with an ability to mentor and train others. - Demonstrated initiative and problem-solving ability. - Deep knowledge and experience billing and collecting major medical claims for home infusion, ambulatory infusion, and/or specialty pharmacy. - Ability to demonstrate a clear understanding of CMS 1500 and 837 claim formatting and billing process. Benefits - Health Insurance - Gap Insurance - Dental Insurance - Vision Insurance - Short Term / Long Term Disability (company paid) - Term Life Insurance (company paid, employee can elect additional) - Full suite of CHUBB supplemental insurance plans, including: Disability Income, Level Term Life, Accident Insurance, & Critical Illness Insurance - Floating holidays and paid time off - 401K with company match

Prochant is seeking an Infusion Reimbursement Manager to work remotely. The Infusion Reimbursement Manager is responsible for managing the billing and collection function for all payer groups including Medicare / Medicaid. Responsible for escalating billing and/or collection issues. This is a highly collaborative role and the ideal candidate can both manage the day-to-day reimbursement as well as document and train other staff. Essential Duties & Responsibilities - Performs and manages the day-to-day reimbursement activities from delivery to payment process for all payer segments. This includes all aspects of the billing and collection functions as outlined in the individual job descriptions - Monitors cash flow, days sales outstanding (DSO), and bad debt losses for payer segment by business to ensure profitability measures are met and maintained. - Monitors billing requirements and receivables pursuant to contracts with third party payers or government programs. - Ensures compliance with federal, state, and local governments, third party contracts, company policy, and general accounting practices. - Manages and analyzes account summaries of outstanding receivable balances for negotiations or settlements. - Revenue review and profitability reporting for accurate margins on a daily, weekly, monthly basis. - Complete Month end required activities per company deadlines - Reviews/statuses adjustments to claim balances and delinquent account transfers to collection agencies according to company procedures and policies. - Acts as the first point of contact for escalation issues from the service provider regarding unresolved unknown deductions on payments received from payer or failure of payer to comply with contract terms as well as for billing and collections issues/claims. - Provides input regarding procedures, develop strategies and new techniques to eliminate errors, increase to cash flow, reduction in avoidable bad debt loss, including recommended changes to billing practices, forms etc. - Supports broader reimbursement team in the formulation of strategies relating to reimbursement management. - Monitors adjustments to claim balances and delinquent account transfers to collection agencies according to company procedures and policies. - Assist with training or onboarding of new employees - Other duties as assigned

This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more. Role Description Prochant is seeking an Infusion Reimbursement Manager to work remotely. The Infusion Reimbursement Manager is responsible for managing the billing and collection function for all payer groups including Medicare / Medicaid. Responsible for escalating billing and/or collection issues. This is a highly collaborative role and the ideal candidate can both manage the day-to-day reimbursement as well as document and train other staff. - Performs and manages the day-to-day reimbursement activities from delivery to payment process for all payer segments. - Monitors cash flow, days sales outstanding (DSO), and bad debt losses for payer segment by business to ensure profitability measures are met and maintained. - Monitors billing requirements and receivables pursuant to contracts with third party payers or government programs. - Ensures compliance with federal, state, and local governments, third party contracts, company policy, and general accounting practices. - Manages and analyzes account summaries of outstanding receivable balances for negotiations or settlements. - Revenue review and profitability reporting for accurate margins on a daily, weekly, monthly basis. - Complete Month end required activities per company deadlines. - Reviews/statuses adjustments to claim balances and delinquent account transfers to collection agencies according to company procedures and policies. - Acts as the first point of contact for escalation issues from the service provider regarding unresolved unknown deductions on payments received from payer or failure of payer to comply with contract terms as well as for billing and collections issues/claims. - Provides input regarding procedures, develop strategies and new techniques to eliminate errors, increase cash flow, and reduce avoidable bad debt loss. - Supports broader reimbursement team in the formulation of strategies relating to reimbursement management. - Monitors adjustments to claim balances and delinquent account transfers to collection agencies according to company procedures and policies. - Assist with training or onboarding of new employees. - Other duties as assigned. Qualifications - 5+ years of home infusion billing and collections experience required. - Knowledge of financial reporting, HIPAA guidelines, federal, state, and local regulations related to healthcare providers, billing and collections. - Experience taking initiative and executing processes resulting in expected outcomes. - Experience with analyzing and reporting data to identify issues, trends, or exceptions to drive improvement of results and find solutions. - Experience providing customer service to internal and external customers, including meeting quality standards for services, and evaluation of customer satisfaction. - CPR+, CareTend or Brightree systems experience preferred. - Excel, Outlook, Word experience. Benefits - Health Insurance - Gap Insurance - Dental Insurance - Vision Insurance - Short Term / Long Term Disability (company paid) - Term Life Insurance (company paid, employee can elect additional) - Full suite of CHUBB supplemental insurance plans, including: Disability Income, Level Term Life, Accident Insurance, & Critical Illness Insurance - Floating holidays and paid time off - 401K with company match