Reimbursement Counselor

Overview

Weare based out of Morristown, NJ and we have been providing contingent labor to our clients for last 25 years. In 2015 we placed more than 6,000 contractors across select 100+ clients that we service. End client for this project is a large legal organization with operations in more than 100 countries and has more than 50,000 employees around the world. For eight consecutive years, Fortune has named this company as World’s ‘Most Admired Companies to work for’.

• Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved
• Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.
• Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
• Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors
• Researches and resolves any electronic claim denials. Researches and resolves any claim denials or underpayment of claims
• Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods.
• General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred. Global understanding of commercial and government payers preferred.

• 2-3 years’ experience in medical or Pharmacy Reimbursement environment.
• Thorough understanding of eligibility, benefits, governance and funding of most health care payers from large national programs to small community programs.
• Thorough understanding of Medicare coverage and benefits
• Those who have successfully completed a Reimbursement Counselor or Benefit Verification Specialist role with Annual Reverification may be a good fit for this role

If interested and want to apply, please contact: