Reimbursement Specialist

Title: Reimbursement Specialist

Location: Remote US

time type

Full time

job requisition id

JR101265

Job Description:

GROW WITH US:
Tandem Diabetes Care creates new possibilities for people living with diabetes, their loved ones, and their healthcare providers through a positively different experience. We’d love for you to team up with us to “innovate every day,” put “people first,” and take the “no-shortcuts” approach that has propelled us to become a leader in the diabetes technology industry.

STAY AWESOME:
Tandem Diabetes Care is proud to manufacture and sell the Tandem Mobi system and t:slim X2 insulin pump with Control-IQ+ technology — an advanced predictive algorithm that automates insulin delivery. But we’re so much more than that. Our company’s human-centered approach to design, development, and support delivers innovative products and services for people who use insulin. Because many of our own team members live with diabetes, or have a loved one impacted by diabetes, the work is personal, and we are committed to the cause. Learn more at tandemdiabetes.com

A DAY IN THE LIFE:

The primary responsibility of this position is to assure all insurance claims are processed timely, accurately, and efficiently. The Reimbursement Specialist is responsible to secure payments from both contracted and non-contracted insurance entities as well as customers. This position will work closely with our Customer Sales Support to assure data accuracy as well as communicating requirements from health insurance plans.

Reimbursement Specialists at Tandem are also responsible for:

• Reviews medical criteria to assure patient documentation meets standards.
• Carefully reviews all patient related data and documentation for accuracy prior to claim submission.
• Creates and submits healthcare claims to insurance companies.
• Communicates with patients to advise on status of insurance claims, as necessary.
• Contacts patients regarding collection of outstanding invoices.
• Fields inbound calls from patients regarding inquiries related to insurance claims.
• Makes outbound investigational calls to insurance providers to determine status of outstanding claims.
• Negotiates structured payment plans.
• Accesses CRM to receive and provide up to date patient claim information.
• Keeps up to date with specifications on all of Tandem products and services.
• Confirms completion of required training plan before assuming job responsibilities.
• Ensures work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements.

WHAT YOU’LL NEED:

• 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).

WHEN & WHERE YOU’LL WORK:

Remote with a shift availability to start at 5am pst.

This position is fully remote and open to candidates within the United States. 

Equipment for the role will be provided and training will occur virtually. 

COMPENSATION & BENEFITS:

The starting base pay range for this position is $23.00 - $25.00 per hour. Base pay will vary based on job-related knowledge, skills, experience and may also fluctuate depending on candidate’s location and the overall job market. In addition to base pay, Tandem offers a competitive compensation package that includes bonus and a robust benefits package.

Tandem offers health care benefits such as medical, dental, vision available your first day, as well as health savings accounts and flexible saving accounts.  You’ll also receive 11 paid holidays per year, a minimum of 20 days of paid time off (with accrual starting on day 1) and you will have access to a 401k plan with company match as well as an Employee Stock Purchase plan. 

Tandem has good cause to conduct a review of criminal history information of candidates for this position, as this role may involve access to proprietary, sensitive and/or confidential information, including customer protected health information. This review is required to ensure that individuals in such roles uphold high standards of trust and integrity so as to protect the interests of our customers, employees, and stakeholders.

SPONSORSHIP:  

Applicants must be authorized to work for any employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time. 

WHY YOU’LL LOVE WORKING HERE:
At Tandem, we believe joy fuels excellence. That's why we've built a workplace that celebrates your achievements and  supports your well-being. Our team thrives on pushing boundaries and fostering growth, all while maintaining a spirit of fun and camaraderie.  

BE YOU, WITH US!

We embrace the value that every single one of us brings to the table.  But sometimes we forget that when we don’t meet 100% of a job description’s criteria – maybe you’re feeling that way right now? We encourage you to apply anyway.  Because we want you to be you, with us. 

Tandem is firmly committed to being an equal opportunity employer and does not discriminate on the basis of age, disability, sex, race, religion or belief, gender identity or expression, marriage/civil partnership, pregnancy/maternity, or sexual orientation.  We are an inclusive organization, and we welcome applications from a wide range of candidates.  Selection for roles will be based on individual merit alone. 

REFERRALS:
We love a good referral! If you know someone who would be a great fit for this position, please share! 

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