Reimbursement Coordinator - Home Infusion

Employment Type: Full-time

Position Overview

The Reimbursement Coordinator is responsible for managing the reimbursement process to ensure timely and accurate payment for products and services provided to patients on behalf of WellSky clients. This role involves overseeing claims processing, payment posting, and follow-up activities, as well as addressing discrepancies and resolving claims denials. This opening is specifically for our Home Infusion team.

Key Responsibilities

• Obtain billing information from clients to generate claims.
• Perform quality assurance (QA) of charges and make necessary modifications to ensure clean claims.
• Submit claims to insurance companies within the timely filing period.
• Prepare and/or print secondary claims that do not automatically cross over from Medicare or other primary payers.
• Track pending claims.
• Utilize reports to identify tasks requiring follow-up.
• Obtain claim status by contacting payers and/or using online claims status systems.
• Research claim payments, partial payments, and over-payments.
• Escalate claims not paid within 60 days or denied appeals for appropriate action.
• Perform collection follow-up actions on assigned primary and secondary claims, as well as patient balances.
• Prepare write-off forms when bad debt is identified, documenting the reason for each write-off.
• Perform other job duties as assigned.

Requirements

• GED or High School Diploma
• At least 1-2 years of relevant work experience

Preferred Qualifications

• Healthcare insurance claims processing knowledge
• Healthcare billing and collections knowledge
• Working knowledge of Word and Excel
• Home infusion and durable medical equipment billing and collection experience
• IV field experience
• Medical billing certification
• Some college education

Job Expectations

• Willingness to work additional or irregular hours as needed.
• Adherence to applicable security policies and procedures to safeguard company and client information.
• Ability to sit and view a computer screen for extended periods.

Company Information

WellSky fosters a culture where independent thinking and collaboration converge. We are driven by innovation, inclusivity, and diverse perspectives. At WellSky, you can make a meaningful difference.

WellSky is an equal opportunity employer, committed to providing employment opportunities to all individuals without regard to race, color, national origin, ancestry, citizenship, age, religion, gender, sex, sexual orientation, gender identity, gender expression, marital status, pregnancy, physical or mental disability, protected medical condition, genetic information, military service, veteran status, or any other status or characteristic protected by law. WellSky is a drug-free workplace.

Applicants for U.S.-based positions must be legally authorized to work in the United States. Verification of employment eligibility will be required at the time of hire. Certain client-facing positions may require compliance with applicable requirements, such as immunizations and occupational health mandates.

Benefits for Full-Time Teammates:

• Excellent medical, dental, and vision benefits
• Mental health benefits through TelaDoc
• Prescription drug coverage
• Generous paid time off, plus 13 paid holidays
• Paid parental leave
• 100% vested 401(K) retirement plans
• Educational assistance up to $2,500 per year

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