Medical Reimbursement Specialist

Responsibilities Submit medical claims to appropriate payer. Ensure resubmission of claims, when applicable, is accurate. Ensure reimbursement of claims by submitting the most appropriate coding for services performed. ICD diagnosis coding, modifier application, and verification of CPT and/or HCPCS codes. Ensure all claims processed through Emdeon (Change Healthcare) are correct and compliant. Perform payer enrollment follow-up. Keep abreast of and comply with coding guidelines and reimbursement reporting requirements. Daily review and follow up on all incomplete electronic provider-billing encounters. Identify issues, correct codes and/or pend due to missing information. Keep up to date on medical insurance rules and proper filing guidelines. Answer patient calls/questions, clinic staff calls, and insurance company calls. Maintain a professional relationship with insurance companies and patients. Other duties as assigned. NOTE: (Converted to bold formatting as plain text guidance.) Qualifications and Requirements Minimum 1 year of medical ICD & CPT coding experience preferred. Electronic Medical Record experience; Emdeon (Change Healthcare) software highly preferred. Certified Pharmacy Tech a plus. Proficient with Microsoft Office Suite. Excellent verbal and written communication skills. Excellent organizational and time management skills. Analytical, problem solving, and critical thinking skills. Ability to organize, coordinate, prioritize, and facilitate ongoing tasks. Ability to work independently and with a team. Education High School Diploma or equivalent required. Medical Billing/Coder Certification from an accredited entity a plus. Physical Demands Requires sitting, standing, and occasional light lifting. Benefits Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance. Time to Recharge: Paid vacation and holiday pay. Focus on Your Wellness: We offer a robust Employee Wellness Program. Invest in Your Future: 401(k) with a company match. Support System: Employee Assistance Program provides confidential support and counseling. Get Rewarded for Referring Great People: Employee referral program. Ready to start your rewarding journey with us? Apply today! ProCare Rx will never ask for a financial commitment from an applicant as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our recruitment team at View email address on click.appcast.io. ProCare Rx is an Equal Opportunity Employer. Equal Opportunity Employer. This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr Procare-Rx