Entry Level Customer Service Reimbursement Specialist

Company: Ascent Services Group
Location: Portland
Posted on: November 22, 2021

Job Description:

REIMBURSEMENT SPECIALISTPortland OR (Remote to start)3+ Month Contract (Possible conversion/extension)Payrate: $23/hourImportant: Our Biotech Client has mandated COVID-19 vaccination for their onsite workforce, effective October 1st, 2021. All external personnel providing services to Our Biotech Client are required to comply with this requirement.This is for Blizzard:*Virtual Interview -*Regular business hours are typically 6 AM to 5 PM*There may be overtime required, weekend work, and work on or around holidays*It is important that they are present for training (typically first 4) and the busy season* No vacation time allowed in January and February* Preference for candidates local to Portland OR area.* Position is Remote until at least March 2022

• The Reimbursement Specialist investigates patients' insurance benefits and obtains prior authorization information for Our Biotech Client products at the patient/family request.
• Investigates patients insurance benefits, mostly on the phone (90%)
• Identifies network providers, provider restrictions, co-pays as needed (90%)
• Documents requirements for prior authorization and medical review process (90%)
• Documents activities appropriately in progress notes (90%)
• Pursue product coverage for patients in accordance with the payers authorization requirements within the departments established performance criteria
• Maintains payer profiles by recording payer specific data promptly into the system
• Convey outcomes of benefit investigation to internal contacts (i.e. case managers)
• Ability to learn processes for multiple products and effectively apply learnings to provide effective reimbursement services
• Conducts all work in a compliant manner. Quality Reviews will be conducted monthly to ensure compliance standards are met.
• Consults with team members on an as needed basis
• This position requires some flexibility in work shift. Business Hours are 5AM-5PM Pacific Standard Time.
• Periodic mandatory additional hours is required
• The successful candidate will demonstrate the following competencies critical to this role:
• Communication Listens well; expresses ideas fluently and logically; is open to input and can be depended on for truthfulness
• Inspiring and Influencing Fosters an exchange of ideas and support; persuades and influences without authority
• Teamwork and Collaboration Creates atmosphere of openness and trust; collaborates; offers support and encouragement
• Achieving Results Is goal directed and persistent; is accountable for meeting commitments; recognizes the contributions of peersQualifications:
  • Bachelor's degree is preferred
  • A minimum of 3 years reimbursement experience preferred
  • Candidate has the ability to work from home as needed
  • Candidate has the ability to protect patient privacy in a home work environment
  • Candidate has a comfortable at home work setup (laptop will be provided, external monitor recommended)
  • Proficient in all aspects of reimbursement preferred (i.e., benefit investigations, payer reimbursement policies, regulatory and administrative rules)
  • Understands reimbursement/funding resources and how to access these resources
  • Knowledge of managed care industry including government payers
  • Excellent investigational and analytical skills with a proven ability to communicate effectively in both written and verbal format
  • Ability to work collaboratively in a team structure and responsibly delegates next steps to appropriate team members
  • Demonstrates effective problem solving and excellent customer service
  • Exceptional attention to detail and ability to prioritize tasks in a fast-paced environment.

Keywords: Ascent Services Group, Portland , Entry Level Customer Service Reimbursement Specialist, Hospitality & Tourism , Portland, Oregon