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REIMBURSEMENT SPECIALIST

Healix

Healix

Sugar Land, TX, USA
Posted on Wednesday, July 24, 2024

Job Details

C9990 - Sugar Land, TX
Fully Remote

Description

Healix Infusion Therapy, LLC is currently seeking a qualified Reimbursement Specialist to join our corporate business office and revenue cycle management teams. This position conducts the evaluation, follow-up and resolution of accounts receivables. Currently, the position is a remote work arrangement and qualified candidates must have access to home internet and a dedicated work space free from distractions. Team members must have excellent communication skills and be able to professionally interact with patients, clients, and colleagues.

Schedule: Monday through Friday; 8:30am to 5:30pm CST

*Work hours are subject to change based on business needs and with supervisor approval.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

Include the following. Other duties may be assigned.

  • Reviews aging reports with management to prioritize aged and high dollar claim resolution.
  • Analyze, identify and communicate trends from aging report that indicate non-payment or slow reimbursement associated with specific payors, therapies, patient accounts and/or clients
  • Receives, investigates and responds to inquiries from payors
  • Responsible for the follow-up of designated accounts.
  • Follow up on denied and short paid claims and payment errors and make applicable corrections for proper adjudication and reimbursement
  • Prepare and submit appeals to overturn payor denials
  • Proactively seeks resolution to billing issues that may arise and communicate findings management and billing team
  • Review claim EOBs and correspondence to resolve denials of non-paid claims
  • Create Ad hoc reports as needed and distributing to requesting party
  • Special Projects as assigned

CORE DUTIES AND RESPONSIBILITIES:

Include the following basic performance factors that all Healix employees are expected to meet.

  • Communicates with clients and fellow employees through written and verbal forms, clearly and timely.
  • Interacts professionally with clients and fellow employees.
  • Cooperates with team members to accomplish departmental goals.
  • Accepts and incorporates changes or new ideas into daily work.
  • Provides service in a responsive, timely and accurate manner to both clients and fellow employees.
  • Understands and adheres to policies and procedures.
  • Arrives at work as scheduled and notifies supervisors in a timely manner of any absences.
  • Recognizes priorities and takes action; makes productive use of time.
  • Strives to resolve problems and conflicts on his/her own initiative.
  • Attempts to create new ideas or new procedures working as part of a group or individually.
  • As a part of your job you will receive protected health information. It is your duty to comply with HIPAA in using and disclosing that protected health information.
  • Ability to remain focused, productive and available during company business hours while working remotely.
  • Maintain and adhere to productivity standards by providing updates of daily tasks completed to management

About Us

Healix is the nation’s leader in providing physician office-based infusion services. Focused on patient and physician peace of mind for 30 years, we offer unparalleled capabilities for optimal patient care, comfort, compliance, clinical outcomes, and research in an outpatient setting.

At Healix, we manage Office Infusion Centers on behalf of physicians, hospitals, and medical institutions, encouraging in-office treatment for optimal patient care. Our company is headquartered in Sugar Land, Texas, a suburb of Houston, where we have helped establish and manage hundreds of infusion centers nationwide. We use our clinical and business expertise to provide integrated solutions for all aspects of the infusion program, including research, all while delivering peace of mind to our clients and their patients.

Studies show that the physician office infusion center setting provides significant site of care benefits for patients, communities, payors, and pharma, including superior clinical outcomes and lower cost of care. Overall patient satisfaction at Healix-managed infusion centers soars, with 98% of patients rating their care as excellent. Our physician clients rely on Healix to handle their infusion center operations and research endeavors. As Healix continues to grow and expand in clinical research, we are dedicated to maintaining focus on patient and physician peace of mind.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

  • Four-year college degree preferred.
  • Two to three years in electronic claims submission and medical collections.
  • Proficiency in MS Excel.
  • Experience in Infusion billing and collections strongly preferred.

CERTIFICATES, LICENSES, REGISTRATIONS

This job does not require any certificates, licenses, or registrations.