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Reimbursement Specialist
Location
United States
Posted
12 days ago
Salary
$23 - $25 / hour
Seniority
Mid Level
Job Description
Reimbursement Specialist
Tandem Diabetes Care
• Assure all insurance claims are processed timely, accurately, and efficiently • Secure payments from both contracted and non-contracted insurance entities as well as customers • Work closely with Customer Sales Support to assure data accuracy and communication of requirements from health insurance plans • Review medical criteria to assure patient documentation meets standards • Carefully review all patient related data and documentation for accuracy prior to claim submission • Create and submit healthcare claims to insurance companies • Communicate with patients to advise on status of insurance claims, as necessary • Contact patients regarding collection of outstanding invoices • Field inbound calls from patients regarding inquiries related to insurance claims • Make outbound investigational calls to insurance providers to determine status of outstanding claims • Negotiate structured payment plans • Access CRM to receive and provide up to date patient claim information • Keep up to date with specifications on all of Tandem products and services • Confirm completion of required training plan before assuming job responsibilities • Ensure work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements
Job Requirements
- BA/BS or equivalent combination of education and applicable job experience
- 2+ years experience in medical billing or equivalent experience
- Experience in a HIPAA controlled environment is required
- Experience billing durable medical equipment is preferred
- Experience in diabetes or other disease management device/diagnostics is preferred
- Understanding of medical billing, insurance claim processing, and follow up procedures
- Understanding of all data required on a Health Care Financing Administration (HCFA) 1500 billing form
- Knowledge of billing codes and modifiers assigned by the Centers for Medicare and Medicaid Services (CMS)
- Ability to understand Explanation of Benefits provided by heath care providers
- Knowledge of claims clearing houses and the basic functionality of these services
- Demonstrated ability to effectively communicate over the phone with customers and insurance companies to resolve clear-cut issues and answer questions according to department protocols and requirements
- Able to effectively share information related to work product in verbal and written form
- Able to contribute to the team by supporting the acceptance of new team members
- Demonstrated ability to work accurately, to follow instructions and schedules, and handle multiple priorities
- Experience with MS Office suite (Word, Excel, and Outlook), Internet, & customer relationship management systems (CRM)
Benefits
- health care benefits such as medical, dental, vision available your first day
- health savings accounts and flexible saving accounts
- 11 paid holidays per year
- a minimum of 20 days of paid time off (with accrual starting on day 1)
- access to a 401k plan with company match
- Employee Stock Purchase plan
