Client Reimbursement Specialist

Job Overview

We are seeking a motivated Client Reimbursement Specialist to join our team, focusing on claims reimbursement and education across Managed Care, Medicare, Medicaid, Veterans Affairs, and Commercial plans. This role demands extensive knowledge of CMS policies and procedures, billing, coding and appeal knowledge within a fast-paced client-centric environment dedicated to high-quality work. The ideal candidate will possess strong communication and customer service skills along with a strong insurance back gound ensuring transparent and up-to-date information while maintaining positive client relationships. Professionalism, trustworthiness, and the ability to collaborate effectively with team members are essential for success in this role.

Essential Functions

• Follow up promptly on any denial specific issue under the direction of the Client Reimbursement Supervisor
• Conduct onboarding/introductory calls
• Educate Sales Representatives/Distributors appropriately regarding Billing and Reimbursement surrounding Medicare, Medicaid, VA and Commercial Plans
• Interpret managed care contracts, Medicare, Medicaid, Veteran Affairs, and Workers Compensation claims to calculate allowable amounts and assess reimbursement appropriateness
• Communicate extensively with Insurance Verification Team regarding account eligibility
• Identify any updates, changes, concerns within CMS.GOV regarding Wound Care
• Conduct all tasks in adherence to policies, procedures, guidelines, internal controls, and established goals
• Collaborate effectively with team members, patients, customers, and insurance carriers
• Manage accounts independently and productively, ensuring professional demeanor and confidentiality
• Operate effectively in stressful environments, demonstrating patience and tact in service delivery
  
  

This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job. Other duties may be assigned.

Qualifications

• 3-4 years of previous billing, coding and appeal experience, with a focus on healthcare insurance across various types.
• Proficiency in medical terminology.
• Ability to work independently and prioritize emergent situations effectively.
• Excellent communication and interpersonal skills.
• Strong time management skills.
• Demonstrates professionalism and good customer service skills.
• Comfortable using critical thinking skills in problem-solving.
• Typing speed of 45-60 words per minute.
• High School Diploma or equivalency required.
• Proficient in Microsoft Office products.
• Experience with electronic patient information systems.
• Previous experience with Electronic Health Record systems preferred, but training provided if needed.
  
  

Location

On-Site – Mesa, AZ or Remote (This person is ideally in MST/PST)

What We Offer

Looking for a company to work for can be a daunting task, but we believe that we stand out from the rest. Our company offers a positive and inclusive work environment, opportunities for growth and development, and a commitment to work-life balance. Join us and become part of a team that values your contributions and invests in your success.

Total Rewards Package

• Competitive Salaries
• Health, Dental, and Vision Insurance
• Retirement Plans
• Tuition Reimbursement
• Generous Paid Time Off
• Employee Assistance Program
• No premium payments
  
  

BioLab Sciences is an Equal Opportunity employer and does not discriminate based on race, ancestry, color, religion, sex, age, marital status, sexual orientation, national origin, medical condition, disability, veteran status, gender identity, or any other basis protected by law.