Reimbursement Specialist

Role Overview

Key Responsibilities

• Respond to patients, attorneys, and insurance representatives with clear account guidance.
• Track outstanding liability claims and follow up to support timely payment.
• Document account activity for compliance and tracking.
• Review and reconcile balances using fee schedules and agreements.
• Submit documentation supporting claim processing.
• Investigate denials and coordinate appeals with supporting information.
• Explain billing statements and insurance coverage details.
• Communicate with carriers to resolve unpaid or delayed claims.

Qualifications

• At least 3 years of primary liability accounts receivable or collections experience.
• Experience with major liability payors, including auto insurance carriers.
• Strong revenue cycle knowledge, preferably in orthopedics or a related specialty.
• Knowledge of medical billing procedures, modifiers, and claim requirements.
• Experience negotiating with attorneys or legal representatives.
• Familiarity with practice management systems; Athena experience is preferred but not required.
• High school diploma or GED is required.

Schedule and Work Arrangement

• This is a full-time Monday through Friday role with a flexible start time between 6:30 AM and 8:30 AM.
• The position is hybrid with approximately two in-office days per month or as needed.
• Onsite training is required for approximately two to three weeks based on individual progress.
• Candidates must live within a reasonable commuting distance and maintain a dedicated work-from-home setup.
• Professional attire is expected during onsite work.

Pay and Benefits

• Pay is $22 to $26 per hour, with up to $27 per hour based on experience.
• The position is eligible for medical, dental, vision, and 401(k) benefits.

Additional Perks

• The role offers flexible start times, remote flexibility, a collaborative environment, exposure to complex liability claims, and career growth potential.