Reimbursement Specialist-RTB

Job Description

Job Description

This position is responsible for the resolution of unbilled tickets with the Ready to Bill file, under AUTH, AUTH PART D, AUTHORIZATION PENDING PD, INS, TERMED PART D and MGMT etc. The role provides exceptional reimbursement expertise to provide support and resources for internal and external customers.

This is a remote role, however you must be available to work 8 : 30am-5pm Eastern Standard Time

Essential Job Duties :

• Address challenges within the RTB, provide appropriate solutions, alternatives and follow up to ensure resolution of RTB tickets and authorization issues.
• Resolves complicated questions or issues relating to patient accounts and provides recommendations for identified deficiencies in current processes, system use or staff knowledge base.
• As needed, verifies insurance coverage and benefits through payor websites, E1 checks or by calling the payor directly. Enters information into CPR+ and communicates as appropriate to team members.
• Apply prior and current knowledge of insurance carrier requirements and authorization practices to capture and communicate appropriate clinical and financial data required to obtain approval / authorization of services, professionally documenting a detailed outcome in CPR+ as needed.
• Other job duties and special projects as assigned.

I deal Candidate Will Have :

Salary Range : $24 hourly

Pentec Health offers a comprehensive compensation and full benefits package. Actual pay will be based on several factors such as qualifications and skills for the role plus geographic location.

Benefits may include but are not limited to medical, dental, vision, 401k match, PTO, paid holidays, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.