Medical Billing Specialist- Reimbursement

$43,680 - $49,920/Yr

United Staffing Associates - Temecula, CA

Full-time - Entry Level

Remote - Temecula, CA

Administrative and Support Services

About the position

The Reimbursement Specialist is a critical role focused on managing and coordinating reimbursement processes from product dispensing to payment resolution. This position requires strong communication skills and the ability to work independently while interacting with various payer representatives and internal personnel. The specialist will ensure compliance with reimbursement policies and maintain accurate records while striving to improve service quality.

Responsibilities

• Submit and follow-up on payer claims including primary, secondary, and tertiary claims.
• Verify accuracy of payments according to the payer's fee schedule.
• Audit accounts receivables including analysis of payments, contractual discounts, and adjustments.
• Draft professional cover letters, appeals, and correspondence related to claims.
• Resolve credit balances through revenue adjustments, balance transfers, and refunds.
• Document all collection efforts within the AR system accurately.
• Complete and submit monthly claim status reports.
• Inform management of reimbursement rates, changes, and issues affecting receivables.
• Maintain reimbursement records in compliance with company policies and procedures.
• Attend departmental meetings and participate in job-related training and educational seminars.
• Comply with safety policies and report any hazards or violations.
• Conduct special projects as requested by management.

Requirements

• High school diploma or equivalent required.
• Three years of healthcare-related experience, such as DME, home care, medical insurance, or medical case management.
• Basic knowledge of medical reimbursement principles.
• Excellent verbal and written communication skills.
• Ability to interact effectively with customers and all levels of management.
• Strong organizational skills and attention to detail.
• Intermediate to advanced Microsoft Office skills.
• Basic to intermediate understanding of Internet technologies, including payer portals.

Nice-to-haves

• Pharmacy or home infusion experience preferred.

Benefits

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance