Overview: The Customer Reimbursement Coordinator is responsible for providing
direct assistance to customers with their reimbursement inquiries and claims.
This role involves verifying insurance benefits, assisting with claims
processing, initiating prior authorizations with payers on behalf of providers,
answering customer queries, and ensuring compliance with reimbursement policies
and regulations. The ideal candidate will have strong communication skills, a
detail-oriented mindset, and experience in customer service or healthcare
reimbursement.
Responsibilities:
Respond to customer inquiries regarding reimbursement policies, claims
status, and procedures via phone, email, and other communication channels
Provide clear and accurate information to customers about the reimbursement
process
Provide appeal and denial support for negative outcome authorization requests
Assist customers in completing and submitting reimbursement claims
Review and verify benefits in accordance with company policies and regulatory
requirements
Verify the accuracy and completeness of claim documentation
Ensure timely and efficient assistance with the processing of claims to meet
customer needs and company standards
Maintain detailed and organized records of customer interactions and claims
processing
Ensure all documentation is accurate, up-to-date, and compliant with relevant
regulations
Prepare and submit reports on reimbursement activities and trends as required
Adhere to all relevant regulations, policies, and procedures related to
reimbursement
Conduct regular quality checks to ensure high standards of service and
compliance
Stay informed about changes in reimbursement policies and procedures and
update customers and internal teams accordingly
Work closely with other departments to resolve complex reimbursement issues
and improve processes
Provide support and assistance to team members as needed
Participate in training and development activities to enhance knowledge and
skills
Skills/Qualifications:
Associate’s degree in business, healthcare administration, or a related field
or equivalent work experience is required, a bachelor’s degree is preferred
Minimum of 4 years of experience in customer service, healthcare
reimbursement, or a related field
Strong understanding of reimbursement processes and regulations
Excellent communication and interpersonal skills
High level of attention to detail and accuracy
Proficiency in using customer support software and office applications
Experience with reimbursement management systems and software
Knowledge of healthcare insurance and billing processes
Certification in healthcare reimbursement or a related field
Please note, we do not provide sponsorship at this time.
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