Reimbursement Specialist

Job Description:

• Obtain and maintain physician orders, authorizations, Certificates of Medical Necessity (CMN), and other supporting documents for reimbursement
• Attend in-service education and training on policies, procedures, and work-related materials such as Medicare Additional Documentation Requests
• Act as an internal resource for qualifying criteria, payment limitations, and required documentation
• Assist patient financial services with accurate patient account charges
• Verify documentation, examine and track orders, and ensure proper billing
• Verify payment balances and receipts and complete End of Day reports
• Schedule and maintain CMNs and physician orders for timely delivery
• Enter completed orders into the billing system for reimbursement
• Research and respond to overdue or delinquent accounts by mail or phone
• Research customer accounts and document appropriately
• Process adjustments when services are non-covered or denied
• Make final independent decisions regarding the accuracy of home medical equipment documentation
• Work as a member of the Home Medical Equipment team to ensure timely and accurate reimbursement

Requirements:

• High school diploma/GED or equivalent working knowledge
• 2-3 years of experience in patient accounts, pharmacy or equipment intake
• Thorough understanding of regulatory and accreditation requirements of medical equipment and infusion medications for government and third party agencies
• Effective interpersonal skills and ability to provide effective customer service
• Demonstrated organizational and problem solving skills
• Ability to keep detailed records regarding equipment and medical records
• Ability to communicate effectively
• Ability to prioritize and organize daily work
• Demonstrated ability to use and develop proficiency with computers and office software
• 1-2 years of experience in clerical, customer relations and/or customer service departments preferred
• Additional related education and/or experience preferred