Reimbursement Specialist

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.

Job Summary

Our client is seeking a dedicated Reimbursement Specialist to manage and optimize the revenue cycle. The primary responsibilities include follow-up and collection strategies for diverse accounts, investigating claim disputes, and ensuring compliance with billing regulations.

Key Responsibilities

• Revenue Cycle Management: Execute comprehensive follow-up and collection strategies for commercial, government, and patient accounts to ensure optimal reimbursement cycles.
• Claims Resolution & Analysis: Investigate claim denials and rejections meticulously. Resolve complex payer issues, document all account activities, and apply necessary adjustments using XiFin to ensure streamlined adjudication.
• Trend Identification: Proactively monitor and report on collection trends or systemic bottlenecks that may lead to delayed processing or increased aging of accounts receivable.
• Stakeholder Relations: Act as a primary liaison between insurance carriers, patients, and internal departments, providing elite-level service while resolving outstanding balances.
• Regulatory Compliance: Maintain a deep, up-to-date understanding of federal, state, and private payer billing regulations to ensure all submissions meet evolving industry standards.

Qualifications

• 3+ years of prior laboratory collections experience, specifically dealing with denials management and reducing aging A/R.
• Comprehensive understanding of lab-related RCM systems, including XiFin, Quadax, Glideon, etc.
• Ability to work effectively in a remote setting, with a distraction-free workspace.
• Experience working a mix of commercial and government payers, and utilizing both calls and portals to obtain reimbursement.
• Preferred: Experience working at diagnostic labs that specialize in oncology testing.

Skills

• Technical skills: Proficiency with RCM systems such as XiFin.
• Soft skills: Strong communication and collaboration skills.

Additional Requirements

• Fully remote work possibility with a flexible schedule, preferably during PST hours (7am-4pm or 8am-5pm).
• Monday-Friday schedule.

Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

Required Employment / Compliance Language

Medix is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or veteran status.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).


Medix Overview:

With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.

* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.