1,769 Reimbursement jobs in the United States
Medical Reimbursement Technician
Posted 3 days ago
Job Viewed
Job Description
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.
Medicare/Medicaid Claims Reimbursement Specialist
Posted 1 day ago
Job Viewed
Job Description
011250 CCA-Claims
This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this time.
Position Summary:
Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the end-to-end review, analysis, and resolution of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and provider engagement initiatives. This role also provides support in managing provider disputes and escalations requiring detailed pricing and reimbursement validation.
Supervision Exercised:
- No, this position does not have direct reports.
Essential Duties & Responsibilities:
-
Analyze MassHealth and Medicare claim reimbursements to ensure compliance with contractual terms, state and federal regulations, and internal payment policies.
-
Resolve provider inquiries and disputes related to pricing discrepancies, contract interpretation, and fee schedule issues.
-
Collaborate closely with Provider Relations, Contracting, Payment Integrity, Appeals & Grievances, and Configuration teams to validate and resolve reimbursement concerns.
-
Conduct retrospective audits to identify systemic payment issues and recommend resolution pathways.
-
Interpret and apply MassHealth fee schedules, All-Payer Rate Setting regulations, and CMS payment methodologies (e.g., DRG, APC, RBRVS).
-
Support provider appeal reviews and internal payment integrity investigations by providing reimbursement validation.
-
Escalate systemic or high-impact discrepancies to the Director of Claims Operations and Quality Assurance for further investigation or configuration updates.
-
Document all research, findings, and outcomes in claims systems (e.g., Salesforce, Facets) in compliance with audit standards and MassHealth requirements.
-
Maintain awareness of MassHealth transmittals, billing guides, and program updates to ensure adherence in payment practices.
-
Ensure SLA compliance for inquiry resolution, appeal response times, and post-payment audits.
-
Assist in the resolution of complex provider disputes and escalations, including direct support to leadership in pricing determinations and dispute case documentation.
Working Conditions:
- Standard office conditions.
Required Education (must have):
- N/A
Desired Education (nice to have):
-
Associate's or Bachelor's degree in Health Administration, Finance, or related field preferred.
-
Certified Professional Coder (CPC) - AAPC
-
Certified Claims Professional (CCP)
-
Other AHIMA or Medicaid billing-related certifications
Required Experience (must have):
-
3+ years in healthcare claims processing, provider reimbursement, or payment integrity.
-
Experience with core claims platforms such as Facets, QNXT, or Amisys.
Desired Experience (nice to have):
- Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred.
Required Knowledge, Skills & Abilities (must have):
-
Proficiency with Excel and reporting tools for data analysis.
-
Understanding of provider contracts, rate tables, and state-set payment methodologies.
-
Strong problem-solving and analytical skills.
-
Effective verbal and written communication with both internal stakeholders and providers.
-
Meticulous attention to detail and documentation standards.
Required Language (must have):
- English
Desired Knowledge, Skills, Abilities & Language (nice to have):
- Knowledge of Facets, MassHealth, and CMS is a plus.
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Medicare/Medicaid Claims Reimbursement Analyst
Posted 10 days ago
Job Viewed
Job Description
Join to apply for the Medicare/Medicaid Claims Reimbursement Analyst role at Commonwealth Care Alliance . Position Summary: Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. This role involves the end-to-end review, analysis, and resolution of complex reimbursement issues, including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies, supporting audit, compliance, and provider engagement initiatives. It also involves managing provider disputes and escalations requiring detailed pricing and reimbursement validation. Essential Duties & Responsibilities: Analyze MassHealth and Medicare claim reimbursements for compliance with contractual terms, regulations, and policies. Resolve provider inquiries and disputes related to pricing, contracts, and fee schedules. Collaborate with various teams to validate and resolve reimbursement concerns. Conduct audits to identify systemic payment issues and suggest resolutions. Interpret and apply relevant fee schedules, regulations, and CMS payment methodologies. Support provider appeal reviews and internal investigations. Escalate discrepancies to leadership for further action. Document all research and outcomes in claims systems in compliance with standards. Stay updated on program changes and ensure adherence in payment practices. Ensure timely resolution of inquiries and disputes. Assist in complex dispute resolution and provide documentation support. Qualifications: 3+ years in healthcare claims processing, provider reimbursement, or payment integrity. Experience with claims platforms such as Facets, QNXT, or Amisys. Knowledge of MassHealth and Medicare Advantage reimbursement rules is preferred. Proficiency with Excel and data analysis tools. Strong problem-solving, communication, and attention to detail skills. English language proficiency. Education: Associate’s or Bachelor’s degree in Health Administration, Finance, or related field (preferred). Certifications like CPC or CCP are a plus. Employment Type: Full-time Seniority Level: Mid-Senior level This job is active and accepting applications. #J-18808-Ljbffr
Medicare/Medicaid Claims Reimbursement Specialist
Posted 13 days ago
Job Viewed
Job Description
011250 CCA-Claims Job Description Position Summary: Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the end-to-end review, analysis, and resolution of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and provider engagement initiatives. This role also provides support in managing provider disputes and escalations requiring detailed pricing and reimbursement validation. Supervision Exercised: No, this position does not have direct reports. Essential Duties & Responsibilities: Analyze MassHealth and Medicare claim reimbursements to ensure compliance with contractual terms, state and federal regulations, and internal payment policies. Resolve provider inquiries and disputes related to pricing discrepancies, contract interpretation, and fee schedule issues. Collaborate closely with Provider Relations, Contracting, Payment Integrity, Appeals & Grievances, and Configuration teams to validate and resolve reimbursement concerns. Conduct retrospective audits to identify systemic payment issues and recommend resolution pathways. Interpret and apply MassHealth fee schedules, All-Payer Rate Setting regulations, and CMS payment methodologies (e.g., DRG, APC, RBRVS). Support provider appeal reviews and internal payment integrity investigations by providing reimbursement validation. Escalate systemic or high-impact discrepancies to the Director of Claims Operations and Quality Assurance for further investigation or configuration updates. Document all research, findings, and outcomes in claims systems (e.g., Salesforce, Facets) in compliance with audit standards and MassHealth requirements. Maintain awareness of MassHealth transmittals, billing guides, and program updates to ensure adherence in payment practices. Ensure SLA compliance for inquiry resolution, appeal response times, and post-payment audits. Assist in the resolution of complex provider disputes and escalations, including direct support to leadership in pricing determinations and dispute case documentation. Working Conditions: Standard office conditions. Required Education (must have): N/A Desired Education (nice to have): Associate's or Bachelor's degree in Health Administration, Finance, or related field preferred. Certified Professional Coder (CPC) - AAPC Certified Claims Professional (CCP) Other AHIMA or Medicaid billing-related certifications Required Experience (must have): 3+ years in healthcare claims processing, provider reimbursement, or payment integrity. Experience with core claims platforms such as Facets, QNXT, or Amisys. Desired Experience (nice to have): Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred. Required Knowledge, Skills & Abilities (must have): Proficiency with Excel and reporting tools for data analysis. Understanding of provider contracts, rate tables, and state-set payment methodologies. Strong problem-solving and analytical skills. Effective verbal and written communication with both internal stakeholders and providers. Meticulous attention to detail and documentation standards. Required Language (must have): English Desired Knowledge, Skills, Abilities & Language (nice to have): Knowledge of Facets, MassHealth, and CMS is a plus. #J-18808-Ljbffr
Medicare/Medicaid Claims Reimbursement Specialist
Posted today
Job Viewed
Job Description
**_This position is available to remote employees residing in Massachusetts. Applicants residing in other states will not be considered at this time._**
**Position Summary:**
Reporting to the Director, Claims Operations and Quality Assurance, the Claims Sr. Analyst plays a critical role in ensuring accurate, compliant, and timely reimbursements within the scope of MassHealth and Medicare Advantage programs. Under the direction of the Director of Claims Operations and Quality Assurance, this role is responsible for the end-to-end review, analysis, and resolution of complex reimbursement issues - including underpayments, overpayments, and disputes. The Claims Sr. Analyst serves as a subject matter expert on Medicaid (MassHealth), Medicare, and commercial payment methodologies and supports audit, compliance, and provider engagement initiatives. This role also provides support in managing provider disputes and escalations requiring detailed pricing and reimbursement validation.
**Supervision Exercised:**
+ No, this position does not have direct reports.
**Essential Duties & Responsibilities:**
+ Analyze MassHealth and Medicare claim reimbursements to ensure compliance with contractual terms, state and federal regulations, and internal payment policies.
+ Resolve provider inquiries and disputes related to pricing discrepancies, contract interpretation, and fee schedule issues.
+ Collaborate closely with Provider Relations, Contracting, Payment Integrity, Appeals & Grievances, and Configuration teams to validate and resolve reimbursement concerns.
+ Conduct retrospective audits to identify systemic payment issues and recommend resolution pathways.
+ Interpret and apply MassHealth fee schedules, All-Payer Rate Setting regulations, and CMS payment methodologies (e.g., DRG, APC, RBRVS).
+ Support provider appeal reviews and internal payment integrity investigations by providing reimbursement validation.
+ Escalate systemic or high-impact discrepancies to the Director of Claims Operations and Quality Assurance for further investigation or configuration updates.
+ Document all research, findings, and outcomes in claims systems (e.g., Salesforce, Facets) in compliance with audit standards and MassHealth requirements.
+ Maintain awareness of MassHealth transmittals, billing guides, and program updates to ensure adherence in payment practices.
+ Ensure SLA compliance for inquiry resolution, appeal response times, and post-payment audits.
+ Assist in the resolution of complex provider disputes and escalations, including direct support to leadership in pricing determinations and dispute case documentation.
**Working Conditions:**
+ Standard office conditions.
**Required Education (must have):**
+ N/A
**Desired Education (nice to have):**
+ Associate's or Bachelor's degree in Health Administration, Finance, or related field preferred.
+ Certified Professional Coder (CPC) - AAPC
+ Certified Claims Professional (CCP)
+ Other AHIMA or Medicaid billing-related certifications
**Required Experience (must have):**
+ 3+ years in healthcare claims processing, provider reimbursement, or payment integrity.
+ Experience with core claims platforms such as Facets, QNXT, or Amisys.
**Desired Experience (nice to have):**
+ Prior experience working with MassHealth and Medicare Advantage reimbursement rules is strongly preferred.
**Required Knowledge, Skills & Abilities (must have):**
+ Proficiency with Excel and reporting tools for data analysis.
+ Understanding of provider contracts, rate tables, and state-set payment methodologies.
+ Strong problem-solving and analytical skills.
+ Effective verbal and written communication with both internal stakeholders and providers.
+ Meticulous attention to detail and documentation standards.
**Required Language (must have):**
+ English
**Desired Knowledge, Skills, Abilities & Language (nice to have):**
+ **Knowledge of Facets, MassHealth, and CMS is a plus.**
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled
Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.
Medical Billing Reimbursement Specialist - Multi Specialty
Posted 9 days ago
Job Viewed
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
Reimbursement Specialist
Posted today
Job Viewed
Job Description
POSITION SUMMARY/RESPONSIBILITIES
Identifies and enrolls indigent and under-insured patients into drug assistance reimbursement programs which provide drug replacement and reimbursement compensation. Monitors contain eligibility status and document drug shipments received through a computerized tracking system. Serves as a resource in facilitating resolution of insurance denial referrals. Communicates effectively with pharmacy, hospital administration, medical staff, patients and personnel in the patient assistance programs using verbal and written interpersonal communication skills. Requires the ability to work independently and coordinate assigned projects efficiently. Effectively utilizes problem-solving ability, significant interpersonal contact and concentration abilities, analytical skills and in-depth knowledge of computer software. Coordinates all information regarding patients enrolled in assistance programs for drug therapies using various computer software programs. Creates, expands and maintains computerized databases to support patient enrollment in assistance programs and tracks case-specific assistance provided in response to reimbursement denials. Conducts patient interviews and conveys reimbursement denial potential to patients and medical staff. Reviews all outpatient 3rd party rejections and assists the patient in resolving the problem. Coordinates 3rd party billing, problems with eligibility, rejections, etc. with the Outpatient Pharmacy Supervisor and the Pharmacy Billing Section.
EDUCATION/EXPERIENCE
Texas State Board of Pharmacy registration required. National Certification as a Certified Pharmacy Technician (CPhT) is recommended. Three (3) years' experience in a medical or pharmacology-related field to include project coordination; database/spreadsheet development and management; and/or application programming; processing and overseeing medical insurance billing and reimbursement cost capture is preferred. Must have demonstrated independent judgment
Be The First To Know
About the latest Reimbursement Jobs in United States !
Reimbursement Specialist
Posted today
Job Viewed
Job Description
POSITION SUMMARY/RESPONSIBILITIES
Identifies and enrolls indigent and under-insured patients into drug assistance reimbursement programs which provide drug replacement and reimbursement compensation. Monitors contain eligibility status and document drug shipments received through a computerized tracking system. Serves as a resource in facilitating resolution of insurance denial referrals. Communicates effectively with pharmacy, hospital administration, medical staff, patients and personnel in the patient assistance programs using verbal and written interpersonal communication skills. Requires the ability to work independently and coordinate assigned projects efficiently. Effectively utilizes problem-solving ability, significant interpersonal contact and concentration abilities, analytical skills and in-depth knowledge of computer software. Coordinates all information regarding patients enrolled in assistance programs for drug therapies using various computer software programs. Creates, expands and maintains computerized databases to support patient enrollment in assistance programs and tracks case-specific assistance provided in response to reimbursement denials. Conducts patient interviews and conveys reimbursement denial potential to patients and medical staff. Reviews all outpatient 3rd party rejections and assists the patient in resolving the problem. Coordinates 3rd party billing, problems with eligibility, rejections, etc. with the Outpatient Pharmacy Supervisor and the Pharmacy Billing Section.
EDUCATION/EXPERIENCE
Texas State Board of Pharmacy registration required. National Certification as a Certified Pharmacy Technician (CPhT) is recommended. Three (3) years' experience in a medical or pharmacology-related field to include project coordination; database/spreadsheet development and management; and/or application programming; processing and overseeing medical insurance billing and reimbursement cost capture is preferred. Must have demonstrated independent judgment
Reimbursement Specialist
Posted today
Job Viewed
Job Description
Reimbursement Specialist Altamonte Springs, FL | $20.00-$23.00/hour | Fully Onsite Support Clean Reimbursements and Timely Expense Processing Join a respected healthcare shared services team as a Reimbursement Specialist. In this role, you'll ensure employees and vendors are reimbursed quickly and accurately, resolving discrepancies and ensuring compliance with internal policies.
What You'll Do as a Reimbursement Specialist:
Review and audit employee expense reports for accuracy and compliance
Ensure correct disbursement of reimbursements via ACH or check
Communicate with employees to resolve errors or missing documentation
Track reimbursement trends and support reporting needs
Maintain detailed logs for audit and policy enforcement
Partner with AP and payroll teams to resolve cross-functional issues
What You Bring as a Reimbursement Specialist:
2+ years of experience in reimbursements, expense processing, or shared services AP
Excellent attention to detail and problem-solving skills
Familiarity with disbursement processes and ERP/expense systems (e.g., Concur, Workday)
Ability to manage high-volume, time-sensitive data
Experience in healthcare or multi-entity environments is a plus
Bring your accuracy and customer service skills to a high-impact Reimbursement Specialist role and join a team that values precision.
Applicants must be authorized to work in the United States without sponsorship.
Reimbursement Analyst
Posted today
Job Viewed
Job Description
JOB DETAILS: Job Title: Reimbursement Analyst Job Location: Cary, NC/Woburn, MA (Hybrid) Job Duration: 6 Months (likely to be extended)
Description:
The Team We are seeking a
Reimbursement Analyst to assist the U.S. Tower division’s Expense Reimbursement team within the Finance Business Operations group. The Expense Reimbursement team analyzes asset-level expenses incurred by the U.S. Tower division and coordinates internally to receive reimbursements from our customers. Day to day you will focus on analyzing SG&A,; capital, and repair and maintenance expenses to determine which are eligible for reimbursement based on shared benefits or contractual obligations. As an Reimbursement Analyst, you will partner cross-functionally and provide easily consumed requests for reimbursement which are well-documented and supported.
Callouts: - Role is hybrid in either
Cary, NC OR Woburn, MA ( Tues- Thurs on site and M/F from home) - Candidate needs to be able to thoroughly read through Contracts and extract key points pertaining to reimbursement terms - 2 years of experience reading contracts needed
Description
• Abstract customer agreements to develop a comprehensive database of opportunities and limitations related to shared and reimbursable expenses. • Strong organizational skills; ability to accomplish multiple tasks within the agreed upon timeframes through effective prioritization of duties and functions in a fast-paced environment. Enable Skills-Based Hiring No