Reimbursement Analyst
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Job Description
Reimbursement Analyst at Gifthealth helping patients access therapy through insurance processes. Managing billing, coding and assisting with complex reimbursement inquiries in a remote capacity.
Responsibilities:
- Assist patients and healthcare providers with moderate to complex billing and coding, insurance benefit investigations, prior authorization, appeals and patient assistance support programs inquiries.
- May include acting as regional contact for senior level client contacts.
- Manage patient cases and interact with external contacts like payers and other stakeholders.
- Assist with coordination of relevant tasks/activities between Gifthealth and the client.
- Review and resolve denied or underpaid insurance claims.
- Identify and assess patient specific insurance coverage options for client specific products.
- Reverify patient benefits at predetermined time frames
- Document all activities in program database within required timelines.
- Research payer medical policy
- Monitor and update payer prior authorization requirements and coverage policies for specified client program.
- Prepare and/or assist with preparation of reports as requested, including adverse event and product complaint reports.
- Review and process documentation to determine patient specific eligibility for client patient support program(s), as appropriate.
- Complete quality monitoring and quality assurance activities, as assigned.
- Travel to and attend client meetings, off-site training, and/or conferences. Travel time estimate: 5%.
Requirements:
- Minimum four years recent healthcare experience (2 years’ direct industry preferred).
- Exhibit proficiency in Microsoft Office products
- Excellent customer service skills (call center experience preferred).
- Advanced problem solving, research and analytical skills.
- Advanced communication skills, both written and verbal.
- Attention to detail, data entry accuracy required.
- Ability to multi-task and manage time independently.
- Client interaction experience preferred.
- Advanced knowledge of medical insurance (public and commercial), billing and coding and associated terminology.
Benefits:
- Health insurance
- Professional development opportunities
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