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Reimbursement Specialist - Infusion

Job in Tigard - Washington County - OR Oregon - USA , 97223
Company: ODS Companies
Contract position
Listed on 2021-02-25
Job specializations:
  • Healthcare
  • Accounting
Job Description & How to Apply Below
Position:  Reimbursement Specialist - Home Infusion
Let's do great things, together

Founded in Oregon in 1955, Moda is proud to be a company of real people committed to quality. Today, like then, we're focused on building a better future for healthcare. That starts by offering outstanding coverage to our members, compassionate support to our community and comprehensive benefits to our employees. It keeps going by connecting with neighbors to create healthy spaces and places, together.

Moda values diversity and inclusion in our workplace. We aim to demonstrate our commitment to diversity through all our business practices and invite applications from candidates that share our commitment to this diversity. Our diverse experiences and perspectives help us become a stronger organization. Let's be better together.

Moda Health is seeking a Reimbursement Specialist. The Reimbursement Specialist is responsible for timely and accurate billing and processing of payments from third party payers and patients.

Primary Functions:

01. Prepare bank deposits and account reconciliations in a timely manner.

02. Process Explanation of Benefits forms (EOBs).

03. Review claims denied for payment or underpaid; resolve discrepancies and resubmit as needed.

04. Post credit for returns, or overpayments; process refunds as needed.

05. Pursue timely collection of unpaid overdue balances; coordinate with collection agencies as needed.

06. Maintain record keeping so that all information is accurate and complete.

07. Process timely and accurate claims to third party payors and patients.

08. Report any misconduct, suspicious or unethical activities to the Compliance Officer.

09. Participate in surveys conducted by authorized inspection agencies.

10. Participate in the pharmacy's Performance Improvement program as requested by the Performance Improvement Coordinator.

11. Participate in pharmacy committees when requested.

12. Participate in in-service education programs provided by the pharmacy.

13. Perform other duties as assigned by supervisor.

Are you ready to be a betterist?

If you're ready to make a difference that matters, we want to hear from you. Because it's time to discover what's possible.

Together, we can be more. We can be better.

Moda Health seeks to allow equal employment opportunities for all qualified persons without regard to race, religion, color, age, sex, sexual orientation, national origin, marital status, disability, veteran status or any other status protected by law.
Position Requirements
Less than 1 Year work experience
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