Reimbursement Operations Support Specialist

Position: Reimbursement Operations Support Specialist

Location: Lone Tree, CO - Hybrid - 2-3 days onsite per week (M-F from 8:00-5:00)

Contract Duration: Through the end of 2026

This is a Contract Position paying between $28/hr per hour depending on the level of experience.

General Description

We are seeking a detail-oriented, systems-savvy Reimbursement Operations Support Specialist to provide short-term support to our Reimbursement Operations (ROPS) team. This role supports the end-to-end reimbursement workflow through order review, documentation collection and validation, benefit investigation, authorization support, and professional communication with insurance providers, recipients, clinicians, and internal partners.

Key Roles And Responsibilities

• Order Review & Reimbursement Triage
• Review submitted orders and supporting files for completeness, accuracy, and alignment with payer criteria and guidelines
• Assess each order holistically, identify outstanding requirements, determine the next best action, and manage follow-up through completion
• Request corrected or replacement documentation when submitted materials do not meet requirements
• Documentation Collection & Validation
• Request, collect, organize, and validate required documentation from recipients, clinicians, insurance providers, and internal partners
• Obtain prescriptions, clinical chart notes, insurance authorizations, financial consent forms, and Advance Beneficiary Notices (ABNs), as applicable
• Follow up consistently on outstanding documentation and patient requirements
• Benefit Investigation & Financial Review
• Complete benefit investigations and financial reviews with commercial payers, including deductibles, coinsurance, out-of-pocket maximums, and insurance allowables
• Prepare and send financial consent letters communicating estimated out-of-pocket responsibility
• Follow up to collect required coinsurance before shipment, when applicable
• Authorization & Payer Coordination
• Coordinate with insurance providers to obtain prior authorizations and resolve payer requirements
• Support one-time rate agreements and in-network waivers when needed to secure appropriate payment arrangements
• Phone & Written Communication
• Place professional, confident outbound calls to insurance providers, recipients, and clinicians to collect information, answer questions, and resolve requirements
• Communicate professionally using approved templates and sound judgment when customization is needed
• Coordinate with internal partners and redirect requests to the appropriate resource when needed
• System & Workflow Management
• Perform accurate, high-volume work across Salesforce Health Cloud, Brightree, and related systems
• Maintain clear, timely notes showing completed work, outstanding items, and the next required action

Requirements

• 1-3 years in reimbursement operations, healthcare administration, insurance support, data entry, operations, or administrative roles
• Experience in high-volume, process-driven environments preferred
• Experience with DME, healthcare reimbursement, insurance verification, benefit investigation, prior authorization, or multiple payer workflows strongly preferred
• Systems Experience (Preferred)
• Salesforce Health Cloud or another healthcare CRM
• Brightree or a similar DME or healthcare workflow management platform
• Skills & Competencies
• Professional, confident phone presence and strong written communication skills
• High attention to detail, organization, and follow-through
• Ability to work independently from queues and worklists, assess orders holistically, and determine the next best action
• Comfort navigating multiple systems and managing structured, recurring work with consistency
• Flexibility, urgency, and the ability to learn and apply changing processes quickly

AimHire is an Equal Opportunity/Affirmative Action Employer.