Medical Reimbursement Specialist

Account Reimbursement Specialist

TwelveStone Health Partners is focused on the medication needs of patients with chronic, complex and rare conditions. For more than 35 years, TwelveStone Health has been dedicated to finding new ways to deliver care designed around the patient. Chronic conditions include Multiple Sclerosis, NMOSD, Myasthenia Gravis, CIDP, ITP, Migraine Prevention, Crohn's Disease, Ulcerative Colitis, Plaque Psoriasis, Alpha 1 Antitrypsin Deficiency, Primary Immunodeficiency, hATTR Amyloidosis, Thyroid Eye Disease, and many others.

For patients, we provide access to the most advanced medications, along with the personal and financial support patients need to live with chronic conditions. For providers, we simplify treatment for complex conditions by eliminating the administrative and clinical burdens placed on your practice when patients need innovative specialty medications.

TwelveStone Health Partners supports the transition from acute to post-acute care environments and the journey from sickness to health. We are currently licensed in 50 states.

We are currently hiring for the position of full-time Account Reimbursement Specialist. This role is responsible for the resolution of insurance and/or patient account balances.

Essential Duties & Responsibilities

• Identify, investigate, and resolve unpaid claims. Utilizing Payor portals to follow up on submitted claims.
• Calling insurance companies when claims are denied. Working with commercial/government payers.
• Researching denials and rejections as well as payor policies.
• Submit claims' reconsiderations and appeals.
• Documenting account activity.
• Managing medical records requests.
• Tracking and trending payor issues.
• Collaborate with Billing, Cash Posting, Contracting and Intake on issues affecting account resolution.
• Follow up with patients on outstanding account balances which include unapplied cash.
• Other duties as assigned.

Requirements

Minimum Qualifications: Minimum of three (3) years' experience in a healthcare setting following up and/or resolving outstanding insurance balances required

Education: High school diploma or GED required.

Experience: Three years of medical insurance collections related experience required. Pharmacy/Infusion experience preferred. Experience and/or knowledge of insurance denials process, health care claims processing/follow-ups required.

Functional Competencies: Denials processing, claims, ability to handle multiple priority and tasks, strong attention to detail, strong verbal and written communication skills, analytical skills, computer skills (Outlook, Excel, Word, etc.).