Full-Time Senior Reimbursement Specialist - Order Entry

As a Senior Reimbursement Specialist - Order Entry, you'll ensure accurate and timely claims submission and reimbursement processing.

Key Responsibilities:

• Lead accurate entry of incoming demographics into billing tool and timely claims submissions.
• Handle complex claim issues and front-end denials, working with payer portals.
• Perform eligibility verification and coordination of benefits.
• Maintain accuracy in data entry and account notations.
• Provide reimbursement guidance to patients.
• Collaborate with teams on payer engagement, claim edits, and process improvements.
• Ensure HIPAA compliance.
• Identify operational efficiencies and contribute to SOP development.
• Support training and knowledge sharing.
• Participate in audits and special projects.

Experience/Skills:

• 3-6 years in high-volume professional/facility billing and reimbursement.
• Expert in order entry and claims submission processes.
• Strong proficiency in billing platforms, payer portals, and laboratory billing systems.
• Experience with Salesforce or similar CRM.
• Proficient in Excel and Microsoft Office Suite.
• Knowledge of national/regional payer requirements and healthcare billing regulations.
• Excellent written and verbal communication skills.

Required: High school diploma or equivalent.

Preferred: Additional coursework/certifications in medical billing/coding or revenue cycle operations.

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