Reimbursement Specialist

About Us:

Palmetto Infusion provides comprehensive ambulatory and home-based infusion services to both acute and chronically ill patients. Our centers care for people by providing patients and their families with a convenient, affordable, and safe place to receive infusion treatments. We strive for more than personal service - always delivering a warm and attentive health care experience that boosts patients' state-of-mind, improves their health, and quality of life.

At Palmetto Infusion, we believe in creating an experience that goes beyond just a job. It's about being part of something bigger than yourself - a connected group of caretakers who work together to restore health and hope to our patients. We call it The Palmetto Experience, and we believe it's what sets us apart from other employers.

For our employees, The Palmetto Experience means we serve and support people in our purpose to restore health and hope, we build a culture of belonging and collaboration, we deliver on our promise to treat people with respect and empathy, and we strive to embrace change and search for new opportunities.

About the Role:

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 - Friday; 8:00 AM - 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 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

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.

OTHER

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.