Reimbursement Specialist
New
V
VeracyteDiagnostics, Healthcare
Remote, Monday through Friday 7:30am-4pm PTFull-TimeMiddle
Salary$24 - $33.50
Apply NowOpens the employer's application page
Job Details
- Experience
- 2+ years of experience in medical billing, insurance claims, or revenue cycle operations
- Required Skills
- SalesforceMicrosoft Excel
Requirements
- High school diploma or GED required; Associate's or bachelor's degree preferred.
- 2+ years of experience in medical billing, insurance claims, or revenue cycle operations.
- Proficiency in Microsoft Office, specifically Word and Excel.
- Experience with payer portals and claim tracking systems.
- Familiarity with HIPAA compliance and healthcare privacy regulations.
- Experience using CRMs like Salesforce and billing software such as Epic, XiFin, or Quadax.
- Strong analytical, interpersonal, and communication skills.
- Ability to meet deadlines and manage multiple projects simultaneously.
- Familiarity with ICD, HCPCS/CPT coding, CMS 1500 claim forms, and Claim Adjustment Reason Codes preferred.
Responsibilities
- Research and monitor billing issues, trends, and potential risks.
- Ensure accurate claim submissions with all pre-claim requirements.
- Track claim status and use reports to manage work in Excel.
- Review denied or unpaid claims and perform corrective actions like resubmission or appeals.
- Navigate payor portals and phone systems to check eligibility, prior authorization, and claim status.
- Verify insurance and patient benefits with Medicare, Medicaid, and private payers.
- Interpret explanation of benefits and provide support for patient financial journeys.
- Perform administrative data entry and update record-keeping systems as requested.
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