Reimbursement Specialist

Reimbursement Specialist Job Description Join a fast-paced revenue cycle team where you’ll take the lead in resolving complex insurance claims, driving timely reimbursements, and making a direct impact on financial performance and operational success. Role responsibilities Manage denied and rejected insurance claims by researching root causes, correcting claim issues, and following up with payers to secure timely reimbursement. Review EOBs, payment variances, aging reports, and negative balances to ensure accurate claim processing. Work directly with insurance payers to resolve denials, authorization issues, filing errors, and reimbursement discrepancies. Escalate recurring payer trends and recommend process improvements or solutions to leadership. Verify patient eligibility and benefits, including qualifying diagnoses, prior testing, and authorization requirements. Interpret insurance benefits and claim outcomes to support accurate billing and reimbursement. Utilize Excel, dashboards, and daily/weekly worklists to track claims activity, monitor productivity, and identify reimbursement trends. Maintain compliance with internal processes, reimbursement standards, and quality expectations. Support team collaboration by assisting with payer resolution efforts across accounts and ensuring timely follow-up on insurance correspondence and outstanding claims. You're the right fit if: You’ve acquired 2+ years of experience in Accounts Receivable Management, Reimbursement, Collections, or Denial Management, with hands‑on experience resolving denied and rejected insurance claims and working directly with payers. Your skills include: Strong denial management and claims troubleshooting abilities Knowledge of insurance payers, including Medicare, Medicaid, Blue Cross Blue Shield and commercial plans. Proficiency in Excel, dashboards, and analyzing payer trends/worklists Ability to verify insurance benefits and interpret EOBs (Explanation of Benefits) Strong computer skills with the ability to navigate multiple systems efficiently You have a bachelor’s degree, High School Diploma or GED, or vocational training in finance, accounting, business administration, economics, or a related field. You must be able to successfully perform the following minimum Physical, Cognitive and Environmental job requirements with or without accommodation for this position. You’re an analytical and detail-oriented professional with strong problem‑solving and communication skills, who thrives working independently in a fast‑paced environment while maintaining a collaborative and adaptable team‑focused mindset. How we work together We believe that we are better together than apart. For our office-based teams, this means working in‑person at least 3 days per week. Onsite roles require full-time presence in the company’s facilities. Field roles are most effectively done outside of the company’s main facilities, generally at the customers’ or suppliers’ locations. This is an office role. Philips Transparency Details The pay range for this position in Chicago, IL and Malvern, PA is $26.00 to $41.00. The actual base pay offered may vary within the posted ranges depending on multiple factors including job-related knowledge/skills, experience, business needs, geographical location, and internal equity. In addition, other compensation, such as an annual incentive bonus, sales commission or long-term incentives may be offered. Employees are eligible to participate in our comprehensive Philips Total Rewards benefits program, which includes a generous PTO, 401k (up to 7% match), HSA (with company contribution), stock purchase plan, education reimbursement and much more. Additional Information US work authorization is a precondition of employment. The company will not consider candidates who require sponsorship for a work-authorized visa, now or in the future. Company relocation benefits will not be provided for this position. For this position, you must reside in or within commuting distance to Chicago, IL or Malvern, PA. Equal Employment and Opportunity Philips is an Equal Employment and Opportunity Employer including Disability/Vets and maintains a drug‑free workplace. #J-18808-Ljbffr