The Reimbursement Specialist supports moderate to complex billing and reimbursement issues for both testing and non-testing revenue. The Reimbursement Specialist works with our RCM vendor to follow up on testing related claims and reimbursement issues as well as patient and client complaints. In addition, this role invoices customers for non-testing services and follows up on outstanding AR. This person must understand healthcare billing as well as other accounts receivable and invoicing processes.

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  Assist the Managed Care with researching and resolving complaints
• Assist Client Services team with researching and resolving billing discrepancies
• Conduct benefits investigation requests received from patient and physicians
• Follow up with patients and payors on escalated requests from billing vendor
• Coordinate collections efforts between RCM and Collection vendors
• Create and submit invoices to customers for non-testing services
• Follow up with customers on outstanding non-testing AR
• Enter, track, and follow up on support tickets opened with the RCM vendor
• Track payor policies and updates

• High School Diploma or GED
• Minimum 4 years’ experience in healthcare billing reimbursement environment
• Advanced knowledge of government and private payor reimbursement required
• Anatomic pathology or diagnostic laboratory experience a plus
• Demonstrated interpersonal skills. The role will require interaction with a wide range of fellow employees, clients, and other internal and external stakeholders
• Maintain a high standard of discipline and professionalism.
• Ability to think creatively and initiate new ideas or solutions to business issues
• Demonstrated commitment, self-motivation, and drive
• Ability to work in a fast paced and deadline driven environment

This job description reflects management’s assignment of essential functions. Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.