Reimbursement Specialist

Job Title

This position is responsible for submitting invoices, applying payments, and following up on outstanding balances to ensure accurate and timely reimbursement. Additional duties include tracking authorizations and maintaining medical records.

Schedule: Monday to Friday, 8:00 AM to 5:00 PM

Minimum Qualifications

• Experience/Education: Prior medical billing experience, high school diploma or equivalent.
• Proficient at partner programs (i.e.: MS Outlook, Word, Excel).
• Ability to cope with an ambiguous, changing environment while under pressure in a calm manner.
• Must be able to work as a team member and develop productive and cooperative working relationships with all members of the Palmetto Infusion team.

Essential Functions

Understands the terms and fee schedule for all contracts for which invoices are submitted. Correctly determines quantities and prices for drugs billed. Verifies that the services and products are correctly authorized and that required documentation is on file. Evaluate all completed prescriptions/authorizations to ensure that the appropriate information has been obtained and documented on appropriate insurance forms for reimbursement and compliance. Update insurance carriers when a change has occurred and obtain revised and/or new patient authorizations. Perform outbound calls to patients, physicians, and insurance companies to identify and gather insurance information, follow up on patient paperwork and authorizations, and update claims status. Verifies that payments received are correct according to the fee schedule. Reviews the payments applied to the patient account to ensure applied correctly. Ensures that secondary bills are mailed within 48 hours of receipt of payment. Notifies the Reimbursement Supervisor if there are overpayments and/or duplicate payments for the same service by submitting a refund request.

About the Benefits

Competitive compensation, comprehensive medical insurance, dental and vision insurance, company life insurance, voluntary life and disability insurance, additional voluntary supplemental plans, flexible spending account (medical and dependent care), health savings account, 401K retirement plan, employee assistance program (EAP), employee discounts, Ramsey SmartDollar program, referral program, tuition assistance, paid time off, 8 paid company holidays.

Patient Advocacy Statement

At Palmetto Infusion we believe that patient advocacy is at the heart of everything we do regardless of our roles within the organization. Each member of our team is dedicated to putting the needs and well-being of our patients first. Whether we're working directly with patients or supporting them behind the scenes our commitment to being a compassionate advocate is paramount. We understand that every interaction every decision and every effort contribute to the quality of care our patients receive. Together we strive to ensure that every individual feels heard supported and empowered throughout their healthcare journey. This dedication to patient-centered care is what creates "The Palmetto Experience" — a standard of excellence that defines us and enriches the lives of those we serve.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the primary functions of this job. While performing the duties of this job the employee may be required to frequently stand, walk, sit, bend, twist, talk, and hear. There may be prolonged periods of sitting, keyboarding, reading, as well as driving or riding in transport vehicles. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include reading distance, computer, and color vision. Talking and hearing are essential to communicate with patients, vendors, and staff.

All employees must uphold the confidentiality of protected health information and follow all HIPAA policies. This position has access to sensitive information and a breach of information may be grounds for immediate termination. We are an equal-opportunity employer and value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.