5 Medical Reimbursement jobs in the United States
Medical Reimbursement Technician
Posted 3 days ago
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Summary This position is aligned under the Veterans Health Administration, Office of Finance, and is physically located in Orlando, Florida at the LAKEMONT ANNEX, Florida-Caribbean Consolidated Patient Account Center (CPAC), in either the Billing or Insurance Verification departments. The Medical Reimbursement Technician performs a broad range of duties to achieve the established Central Office VISN expected results for medical billing, and reimbursable and non-reimbursable collections. Responsibilities THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION This is a multi-grade career ladder position. The major duties listed below represent the full performance level of GS-6. At the GS-5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher-level work, and availability of funds. Validate claims for billing purposes ensuring eligibility and referring questionable coding for review. Submit claims to 3rd party health Insurance Carriers, with knowledge of Medicare coverage benefits. Interprets third party insurance policies and requirements for billing. Take responsibility for Medicare reimbursable billing activities. Follow instructions about timeliness, objectives, and relative priorities for doing work. Handle conflicting goals, objectives, priorities, time-lines, and deadlines. Exhibit flexibility in adapting to changing demands within specific time lines. Accept and completes work provided by a standardized control system such as batched work, caseload level, or other defined structure. Use a wide range of office software applications such as Microsoft Access, Excel, and Word. Compose correspondence on a situational basis. Process billings using ICD-10-MC, CPT/4, and HCPCS codes timely. Promotion Potential: The selectee may be promoted to the full performance level without further competition when all regulatory, qualification, and performance requirements are met. Selection at a lower grade level does not guarantee promotion to the full performance level. Work Schedule: 8:00am - 4:30pm Compressed/Flexible: Not Authorized Telework: Not Authorized Virtual: This is not a virtual position. Position Description/PD#: Medical Reimbursement Technician/PD36018A and PD36017A Relocation/Recruitment Incentives: Not Authorized Critical Skills Incentive (CSI): Not Approved Permanent Change of Station (PCS): Not Authorized Requirements Conditions of Employment You must be a U.S. Citizen to apply for this job Selective Service Registration is required for males born after 12/31/1959 You may be required to serve a probationary/trial period Subject to background/security investigation Selected applicants will be required to complete an online onboarding process. Acceptable form(s) of identification will be required to complete pre-employment requirements ( Effective May 7, 2025, driver's licenses or state-issued dentification cards that are not REAL ID compliant cannot be utilized as an acceptable form of identification for employment. Participation in the seasonal influenza vaccination program is a requirement for all Department of Veterans Affairs Health Care Personnel (HCP) Qualifications To qualify for this position, applicants must meet all requirements by the closing date of this announcement, 07/25/2025. (GS-06 Only) Time-In-Grade Requirement: Applicants who are current Federal employees and have held a GS grade any time in the past 52 weeks must also meet time-in-grade requirements by the closing date of this announcement. For a GS-06 position you must have served 52 weeks at the GS-05. The grade may have been in any occupation, but must have been held in the Federal service. An SF-50 that shows your time-in-grade eligibility must be submitted with your application materials. If the most recent SF-50 has an effective date within the past year, it may not clearly demonstrate you possess one-year time-in-grade, as required by the announcement. In this instance, you must provide an additional SF-50 that clearly demonstrates one-year time-in-grade. Note: Time-In-Grade requirements also apply to former Federal employees applying for reinstatement as well as current employees applying for Veterans Employment Opportunities Act of 1998 (VEOA) appointment. GS-05 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-04 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Follows instructions about timeliness, objectives and relative priorities for doing administrative work. Communicates with other staff as necessary to discuss administrative concerns. Reviews and determine the appropriateness of administrative data. OR, GS-05 Substitution of Education for Experience: Applicants may substitute education for the required experience. To qualify based on education for this grade level you must have 4 years above high school. (TRANSCRIPTS REQUIRED) OR, GS-05 Combination of Education and Experience: Applicants may also combine education and experience to qualify at this level. You must have a combination of specialized experience and education beyond 4 years above high school. (TRANSCRIPTS REQUIRED) GS-06 Specialized Experience: You must have one year of specialized experience equivalent to at least the next lower grade GS-05 in the normal line of progression for the occupation in the organization. Examples of specialized experience would typically include, but are not limited to: Follows instructions about timeliness, objectives and relative priorities for doing administrative work. Communicates with other staff as necessary to discuss administrative concerns. Reviews and determine the appropriateness of administrative data. Validates claims for billing purposes ensuring eligibility and referring questionable coding for review. Interprets insurance policies and requirements for billing. You will be rated on the following Competencies for this position: Customer Service (Clerical/Technical) Decision Making Manages and Organizes Information Self-Management Technical Competence Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religions; spiritual; community; student; social). Volunteer work helps build critical competencies, knowledge, and skills and can provide valuable training and experience that translates directly to paid employment. You will receive credit for all qualifying experience, including volunteer experience. Note: A full year of work is considered to be 35-40 hours of work per week. Part-time experience will be credited on the basis of time actually spent in appropriate activities. Applicants wishing to receive credit for such experience must indicate clearly the nature of their duties and responsibilities in each position and the number of hours a week spent in such employment. Physical Requirements: The work is primarily sedentary with long periods of sitting at a desk, working with computers daily. Some work may require walking in offices and similar areas for meetings. Work may also require walking and standing in conjunction with travel to and attendance at meetings and conferences away from the worksite. The work does not require any special physical effort. For more information on these qualification standards, please visit the United States Office of Personnel Management's website at Education As a general rule, education is not creditable above GS-05 for most positions covered by this standard; however, graduate education may be credited in those few instances where the graduate education is directly related to the work of the position. A transcript must be submitted with your application if you are basing all or part of your qualifications on education. Note: Only education or degrees recognized by the U.S. Department of Education from accredited colleges, universities, schools, or institutions may be used to qualify for Federal employment. You can verify your education here: If you are using foreign education to meet qualification requirements, you must send a Certificate of Foreign Equivalency with your transcript in order to receive credit for that education. For further information, visit: Additional Information Receiving Service Credit or Earning Annual (Vacation) Leave: Federal Employees earn annual leave at a rate (4, 6 or 8 hours per pay period) which is based on the number of years they have served as a Federal employee. Selected applicants may qualify for credit toward annual leave accrual, based on prior work experience or military service experience. This credited service can be used in determining the rate at which they earn annual leave. Such credit must be requested and approved prior to the appointment date and is not guaranteed. This job opportunity announcement may be used to fill additional vacancies. If you are unable to apply online or need an alternate method to submit documents, please reach out to the Agency Contact listed in this Job Opportunity Announcement. Under the Fair Chance to Compete Act, the Department of Veterans Affairs prohibits requesting an applicant's criminal history prior to accepting a tentative job offer. For more information about the Act and the complaint process, visit Human Resources and Administration/Operations, Security, and Preparedness (HRA/OSP) at The Fair Chance Act.
Medical Billing Reimbursement Specialist - Multi Specialty
Posted 9 days ago
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Job Description
Job Type Full-timeDescriptionJoin our exciting Billing Team! If you are looking for some challenges, career growth, step up in your billing knowledge this is the right opportunity for you!We are looking for detailed, energetic, focused medical billers who are high achievers and take their career seriously.Job Opening Opportunities:Charge Entry/AR Follow up Specialists openings are available in the following specialties: Imaging, Thoracic, General Surgery, Colorectal, Podiatry, Pain Management, Orthopedics, Radiation Oncology and Call Center.Previous medical billing experience or experience with EPIC/ECW/Athena software is a plus About Us:BASS Medical Group is a large physician owned, physician directed, and patient centered organization. Our goals are to provide high quality, cost effective, integrated, healthcare and physician services. To preserve community based independent physician practice locations throughout California. At BASS Medical Group, our practices are closer and more connected to the people and neighborhoods we serve. With a more personal touch to healthcare and easier access to the care you need, we help guide patients to the best possible outcome.RequirementsRecommend knowledge and skills :Superior phone communication skills with providers, carriers, patients, and employeesExceptional written and verbal communication skillsStrong attention to detailAbility to work in a fast-paced, high-volume work environmentPositive attitudeGreat attendance and punctualityKnowledge of modifiers, insurance plans, and follow up techniquesJob Duties but are not limited to:Perform the day-to-day billing and follow-up activities within the revenue operationsWork all aging claims from Work Ques or Aging reportsPresent trends or issues to supervisor, and work together to make improvementsResolve denials or correspondences from patients and insurance carriersAssist in patient calls and questionsFollow team and company policiesMeet productivity standardsWrite clear and concise appeal lettersMinimum qualifications:High School diploma or equivalentMedical Billing Certificate preferred orAt least a year of Medical billing experienceProficiency with Microsoft office applicationsBasic typing skillsLocation: Walnut Creek, CA or Brentwood, CA (Depending on Experience)Salary: based on experiencePay Scale/Ranges:$21.00 - $2.00/hour*Employees actual pay rate will depend on a host of factors including, without limitation, job location, specialty, skillset, education, and experience. The pay scale/ranges shown are representative of the pay rates for the job title reflected above, but an employees actual pay rate will be determined on a case-by-case basis.Benefits: Medical, Dental, Vision, LTD, Life, AD&D, Aflac insurances, Nationwide Pet Insurance, FSA/HSA plans, Competitive 401K retirement plan. Vacation & Sick Leave, 13 Paid Holidays per yearJob Type: Full-timeSalary Description 16.50- 32.00/hour
Medical Information Replacement, Credit and Reimbursement Specialist
Posted 14 days ago
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Job Description
Location: Titusville, NJ, 08560
Duration: 09 Months
Pay Range: $(62.00 - 64.24)/hr on W2
Job Description:
- The client is looking for a skilled replacement, credit, and reimbursement Specialist to join their team in Titusville, NJ.
- The ideal candidate will be responsible for developing and implementing efficient processes for managing credits and reimbursements in compliance with regulatory requirements and government-funded programs, crucial for upcoming product launches.
- Develop and implement efficient processes for managing credits and reimbursements, ensuring alignment with applicable regulatory and government-funded program requirements.
- Collaborate with cross-functional teams to ensure that the credit and reimbursement strategies support our upcoming product launches.
- Analyze and understand wholesaler acquisition costs (WAC) to ensure our pricing strategies are competitive and compliant with government policies.
- Work closely with government agencies to facilitate the clearance of credits and reimbursement claims, maintaining effective communication and relationships.
- Stay updated on changes in regulations and government policies that impact reimbursement processes and communicate these to relevant stakeholders.
- Support the development of training materials and educate internal teams on best practices related to credits and reimbursements.
- Contribute to strategic planning for product launches with a focus on reimbursement and pricing strategies.
- Bachelor's degree in healthcare, finance, business administration, or a related field.
- Proven experience working in credit and reimbursement roles, particularly with government agencies.
- Expertise in wholesaler acquisition costs (WAC) and its implications for product pricing and reimbursement strategies.
- Prior experience supporting a product launch, particularly in a regulated environment, is highly desirable.
- Ability to work independently, is detailed oriented, and must have excellent oral/written communication skills.
- Strong analytical skills with the ability to interpret complex regulations and policies.
- Excellent communication and interpersonal skills, with the ability to work effectively in a team environment
- Experience and demonstrate proven technical and computer skills, including standard MS Office Software.
- Project Management experience preferred.
- Highly skilled in customer service.
- Ability to understand root cause of issues and effectively resolve customer inquiries which may involve extensive analysis and research.
- Demonstrated analytical, problem-solver with solid organizational, and interpersonal skills.
- Excellent time management, planning and organizational skills.
- Meet challenging goals and timelines; quickly changes plans when data or actions require it.
- Able to work in a fast-paced
- Experience in establishing new work instructions (WI) and/or standard operating procedures (SOP)
- Familiarity with government-funded programs and their reimbursement processes.
- Experience in developing and implementing innovative solutions to streamline reimbursement processes.
- Knowledge of pharmaceutical and healthcare industry trends and challenges.
- Secondary Responsibilities:
- Technology and Capabilities Support for GxP systems
- System Training Administrator
- UAT and Off-Script testing for GxP systems
- Project Coordination and Logistical Support o Documentation Review (SOPs, Training, etc.)
- Training and Processes Support
- Support training and compliance programs and process meetings/updates.
- Perform training content reviews, training updates and suggest opportunities for training improvements/content.
- Sharing knowledge and guidance regarding training and compliance trends.
- Settlements
- Process customer requests for product replacements, credits and refunds, including contacting customers (HealthCare Professionals or Consumers) via multiple channels (Genesys).
- Documenting in CRM system (i.e. Client.com).
- Administrative Support:
- Process hardcopy mail.
- Administrative duties as needed.
- Preferred Requirements:
- Knowledge and support of client IT tools including, but not limited to:
- Client.com/iConnect/Genesys Cloud
- Knowledge of Contact Center processes and policies o Knowledge of Medical Information processes and policies
- Knowledge of Pharmaceutical Industry standards and compliance qualifications
- Structured environment with a team approach.
Medical Information Replacement, Credit and Reimbursement Specialist
Posted 24 days ago
Job Viewed
Job Description
Location: Titusville, NJ, 08560
Duration: 09 Months
Pay Range: $(62.00 - 64.24)/hr on W2
Job Description:
- The client is looking for a skilled replacement, credit, and reimbursement Specialist to join their team in Titusville, NJ.
- The ideal candidate will be responsible for developing and implementing efficient processes for managing credits and reimbursements in compliance with regulatory requirements and government-funded programs, crucial for upcoming product launches.
- Develop and implement efficient processes for managing credits and reimbursements, ensuring alignment with applicable regulatory and government-funded program requirements.
- Collaborate with cross-functional teams to ensure that the credit and reimbursement strategies support our upcoming product launches.
- Analyze and understand wholesaler acquisition costs (WAC) to ensure our pricing strategies are competitive and compliant with government policies.
- Work closely with government agencies to facilitate the clearance of credits and reimbursement claims, maintaining effective communication and relationships.
- Stay updated on changes in regulations and government policies that impact reimbursement processes and communicate these to relevant stakeholders.
- Support the development of training materials and educate internal teams on best practices related to credits and reimbursements.
- Contribute to strategic planning for product launches with a focus on reimbursement and pricing strategies.
- Bachelor's degree in healthcare, finance, business administration, or a related field.
- Proven experience working in credit and reimbursement roles, particularly with government agencies.
- Expertise in wholesaler acquisition costs (WAC) and its implications for product pricing and reimbursement strategies.
- Prior experience supporting a product launch, particularly in a regulated environment, is highly desirable.
- Ability to work independently, is detailed oriented, and must have excellent oral/written communication skills.
- Strong analytical skills with the ability to interpret complex regulations and policies.
- Excellent communication and interpersonal skills, with the ability to work effectively in a team environment
- Experience and demonstrate proven technical and computer skills, including standard MS Office Software.
- Project Management experience preferred.
- Highly skilled in customer service.
- Ability to understand root cause of issues and effectively resolve customer inquiries which may involve extensive analysis and research.
- Demonstrated analytical, problem-solver with solid organizational, and interpersonal skills.
- Excellent time management, planning and organizational skills.
- Meet challenging goals and timelines; quickly changes plans when data or actions require it.
- Able to work in a fast-paced
- Experience in establishing new work instructions (WI) and/or standard operating procedures (SOP)
- Familiarity with government-funded programs and their reimbursement processes.
- Experience in developing and implementing innovative solutions to streamline reimbursement processes.
- Knowledge of pharmaceutical and healthcare industry trends and challenges.
- Secondary Responsibilities:
- Technology and Capabilities Support for GxP systems
- System Training Administrator
- UAT and Off-Script testing for GxP systems
- Project Coordination and Logistical Support o Documentation Review (SOPs, Training, etc.)
- Training and Processes Support
- Support training and compliance programs and process meetings/updates.
- Perform training content reviews, training updates and suggest opportunities for training improvements/content.
- Sharing knowledge and guidance regarding training and compliance trends.
- Settlements
- Process customer requests for product replacements, credits and refunds, including contacting customers (HealthCare Professionals or Consumers) via multiple channels (Genesys).
- Documenting in CRM system (i.e. Client.com).
- Administrative Support:
- Process hardcopy mail.
- Administrative duties as needed.
- Preferred Requirements:
- Knowledge and support of client IT tools including, but not limited to:
- Client.com/iConnect/Genesys Cloud
- Knowledge of Contact Center processes and policies o Knowledge of Medical Information processes and policies
- Knowledge of Pharmaceutical Industry standards and compliance qualifications
- Structured environment with a team approach.
Finance Manager/Chief Accountant | Benefits Include: Tuition Reimbursement, Medical, Dental, Visi...
Posted today
Job Viewed
Job Description
At Hyatt, we believe in the power of belonging- of making people feel at home no matter where they are in the world. We turn trips into journeys, encounters into experiences, and jobs into careers. Join a team that is making travel more human. Connected. Sustainable. Here, everyone's role matters. Opportunities are yours to shape. Your individuality is celebrated. At the heart of Hyatt is our shared belief that hospitality is more than just a job - it's a career for people who care.
Grand Hyatt DFW, located inside Dallas Fort Worth Airport Terminal D, is steps from TSA checkpoints and offers direct access to all terminals. Our luxury hotel rooms and suites offer amazing runway views. Plus, our guests get to enjoy on-site dining and craft cocktails at Grand Met restaurant and bar. Full-service meeting or event spaces are the perfect setting for their next upscale business meeting.
_As Finance Manager, you'll oversee all accounting and general ledger functions at the hotel, supervising finance staff and ensuring alignment between operations and financial strategy. This on-site, non-exempt role reports directly to the Director of Finance and is based on a 45-hour workweek._
**_Key Responsibilities:_**
_·_ _Oversee accounting records, reconciliations, and financial closings_
_·_ _Lead Accounts Receivable and Accounts Payable teams_
_·_ _Manage cash handling, deposits, audits, and reconciliations_
_·_ _Support group billing, commissions, and billback processes_
_·_ _Ensure accuracy in daily reporting and partner with operations on productivity_
_·_ _Maintain compliance with Hyatt's global policies and procedures_
_·_ _Assist with financial analysis and special projects_
_·_ _Promote financial literacy across hotel departments_
**We Offer Excellent Benefits:**
+ Free Room Nights, Discounted and Friends & Family Room Rates
+ Medical, Prescription, Dental, and Vision Insurance
+ 401K with company match
+ Paid vacation, sick days, new child leave, and personal day
+ Paid Family Bonding Time and Adoption Assistance
+ Tuition Reimbursement
+ Free colleague meals during shift
+ Employee Stock Purchase Plan
+ Discounts at various retailers - Apple, AT&T, Verizon, Headspace, and many more
Why make a good decision when you can make a Classic one by applying for your next career opportunity with a Grand Hyatt hotel? Grand Hyatt hotels provide superior services and elevated experiences. Looking for a Classic beginning in your next career? Apply today at careers.hyatt.com.
**Qualifications:**
_·_ _Degree in Hospitality or Accounting preferred_
_·_ _2 years of progressive accounting experience (hotel experience a plus)_
_·_ _Proficiency in Excel, Word, and financial systems (Opera, PMS, MICROS, ADP, Dimensions)_
_·_ _Strong communication and customer service skills_
_·_ _Proactive, independent, and adaptable mindset_
_·_ _High attention to detail and ability to multitask_
_·_ _Eagerness to learn and grow in a dynamic environment_
**_All qualified candidates will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status._**
**Primary Location:** US-TX-DFW Airport
**Organization:** Grand Hyatt DFW
**Pay Basis:** Yearly
**Job Level:** Full-time
**Job:** Accounting/Finance/Tax
**Req ID:** DFW006342
Hyatt is an equal employment opportunity and affirmative action employer. We do not discriminate on the basis of race, color, gender, gender identity, sexual orientation, marital status, pregnancy, national origin, ancestry, age, religion, disability, veteran status, genetic information, citizenship status or any other group protected by law.
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