Reimbursement Coordinator – Infusion at WellSky

Location: Remote, US
| Full-time
WellSky

Title: Reimbursement Coordinator – Infusion

WellSky Reimbursement Services is a Home Infusion Reimbursement business. We are a part of the WellSky family. Looking for a career that will stimulate your analytical thinking? The individuals who excel in this role are highly ambitious, results driven, and willing to “think outside the box”. This position requires a high level of professional customer service, attention to detail, and the ability to work well as part of a fast paced team. The ideal candidate for this position has a high level of multitasking abilities and is driven by moving metrics to achieve success!

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. Perform 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.

A day in the life!

You will be responsible for the following:

  • Obtain billing information from Clients and generate daily claims.
  • Perform Q.A. of charges received from Clients and make modifications/changes as required to produce a clean claim
  • Review contract/details of new payers before billing. Work with supervisor/manager on changes needed in the billing system (e.g., CPR+, CareTend)
  • Track pending claims.
  • Submit claims to insurance companies in a timely fashion and within the individual insurance company’s timely filing period.
  • Prepare and/or print all secondary claims that do not automatically cross over from Medicare or other primary payer
  • Follow up on patient balances within established timeframes.
  • Obtain claim’s status by calling the payer and/or using an online payer portal.
  • Utilize reports to determine tasks that require follow up.
  • Take appropriate action for escalating claims not paid within 60 days or for denied appeals.
  • Prepare write-off request when bad debt is identified. Document description of the reason for the write-off.
  • Research claim payments, partial payments, over payments.
  • Prioritize claims to identify Top Ten high balance accounts. Keep accounts current until complete. Prepare report of Top Ten accounts monthly for supervisor/manager review.
  • Prepare status report with supporting documentation of all claims over 90/120 days.

Do you have what it takes?

  • Healthcare insurance claims processing knowledge
  • HC billing knowledge
  • HC collections knowledge
  • working knowledge of word and excel

Required Experience:

  • High school diploma or GED.
  • Two years of billing and/or collections or insurance claims processing

Do you stand above the rest?

Preferred Experience:

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

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