Reimbursement Coordinator

Key Responsibilities:

As a Reimbursement Coordinator, your primary focus will be on orchestrating the reimbursement process for home infusion services. This includes managing billing procedures, resolving complex claims, and staying abreast of regulatory changes to maintain compliance. Engage with internal and external stakeholders to streamline processes and optimize revenue outcomes. Your role will also involve collaborating with cross-functional teams to achieve service and sales goals.

Requirements:

• Minimum of 2 years of home infusion billing experience.
• 2 years of experience in maintaining HIPAA standards.
• Proficient in using computers and Microsoft products (Excel and Word).
• Strong motivation in billing, claims, and document management.
• Effective communication skills and problem-solving abilities.
• High school diploma required; equivalent education and experience considered.

Preferences:

• Broad knowledge of routines and procedures.
• Proven track record of working towards and exceeding metrics.

PMO Notes:

• We highly recommend posting the job under a different title. Some examples: "Billing Coordinator, Home Infusion"; "Payor Analyst, Home Infusion"; "Reimbursement Coordinator, Home Infusion"; "RCM Specialist, Home Infusion."
• The candidate must have Home Infusion experience. We are looking for at least 2 years of experience as they have to understand the home infusion reimbursement process.
• At least 1 year of experience must be recent/current exp. In addition to Home Infusion experience, they should have knowledge from a Front-End Billing perspective.
• This role primarily focuses on Accounts Receivable, so candidates should have relevant experience in this area.
• Accounts Receivable and Collections (specifically Payor Collections, not Patient Collections).
• The team clarified that the Front-End Billing exp they need is not intake (qualifying patients, test claims, etc.). They need the skillset to create infusion claims (bill medical payors, not the RX payors/NCPP). In an ideal world, they also have knowledge of Collections. This is a plus but not required. Both Home Infusion and Front-End Billing experience are required.
• Soft Skills: The candidate should be motivated, have critical thinking skills, and be able to take ownership of their job duties. Recommended to target candidates from CVS Health/Quorum, as their home infusion departments are closing.

MUST HAVE:

• High school diploma required; equivalent education and experience considered.
• 2 years of home infusion billing experience.
• 2 years of experience in home infusion reimbursement process.
• 2 years of experience in maintaining HIPAA standards.
• This role primarily focuses on Accounts Receivable, so candidates should have relevant experience in this area.
• Accounts Receivable and Collections (specifically Payor Collections, not Patient Collections).
• Experience in Front-End Billing.
• Proficient in using computers and Microsoft products (Excel and Word).
• Strong motivation in billing, claims, and document management.