Reimbursement Specialist Neighborhood Diabetes
THIS JOB HAS EXPIRED Job Description :
Position Overview: Responsible for identifying appropriate candidates for durable medical equipment services
JOB / DUTIES / RESPONSIBILITIES
Ensures that the patients? insurance covers treatment
Reviews appropriateness of CPT/ICD 9 coding and determines if care provided corresponds to the charges submitted
Responsible for obtaining initial and ongoing insurance/managed care benefits for insurance providers
May assist in identifying fraudulent non-plan billing practices and assists in pres and post payment audit preparations with department manager
Gathers pertinent information from insurance carriers, financial counselors, and other ancillary staff to make certain the patient is not financially obligated for services provided
Responsible for receiving, responding to, and directing member phone calls. Ensures new client generation by responding to questions quickly and thoroughly to maximize customer satisfaction. Provides available information upon request and escalates issues as appropriate
Maintains confidentiality per HIPAA guidelines
Verify daily insurance eligibility for all DME orders
Address member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation, and referrals/authorizations for medical care
Print client orders and insure correct product is being sent and is within insurance specifications and limitations
Perform a variety of administrative tasks and projects
Knowledge / Education
Bachelor?s degree preferred
Minimum of 1 year in a professional setting.
High volume customer service experience is a plus.
Previous experience with insurance is preferred.
Skills / Competencies
Extremely efficient, organized and resourceful.
Ability to work independently and as a member of a team
Must be flexible and able to function well in a fast-paced environment.
Great interpersonal skills to deal with many personalities.
Strong decision making skills, verbal and written communication skills and attention to detail are important traits.
Requires sitting and standing associated with a normal office environment.
Manual dexterity needed for using a calculator and computer keyboard.
Lightweight lifting may be required
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
||Bedford, MA |
THIS JOB HAS EXPIRED