Reimbursement Specialist

Job not on LinkedIn

🔥 4 minutes ago

🐊 Florida – Remote

🐊 Florida – Remote

⏰ Full Time

🟢 Junior

🟡 Mid-level

🚫👨‍🎓 No degree required

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 14%

What it means: the chance that no one is really hiring for this job.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Advanced Rx

WebsiteLinkedInAll Job Openings

11 - 50 employees

Founded 2014

🏥 Healthcare

🏭 Manufacturing

💊 Pharmaceuticals

Healthcare • Manufacturing • Pharmaceuticals

Advanced Rx is a company whose name implies it operates in the pharmaceutical or pharmacy space, but the provided text contains no substantive information beyond the name. Based solely on the name, it likely offers prescription drugs, pharmacy services, or related pharmaceutical products or services; however, there is insufficient public detail to be more specific.

📋 Description

• Manage the full billing and collections lifecycle for a defined book of Workers’ Compensation and Personal Injury prescription claims • Maintain and thoroughly work a minimum of 40+ patient accounts • Review and prioritize aging reports daily to reduce 60/90/120+ day accounts receivable and accelerate reimbursement • Analyze EOBs, notices of disallowance, state fee schedule variances, and payment discrepancies • Execute resolution strategies including corrected claim submission, appeals, adjuster outreach, escalation, and legal follow-up • Track and resolve unpaid and underpaid claims in accordance with contractual terms and state fee schedules • Prepare and submit timely appeals with complete medical and billing documentation • Review and correct demographic information, insurance data, ICD-10 diagnoses, CPT coding, and billing modifiers • Identify denial patterns and recurring payer issues and support process improvements • Maintain detailed account documentation for compliance, reporting, and follow-up • Communicate with insurance carriers, adjusters, attorneys, and internal clinical teams • Meet or exceed KPIs for AR reduction, collection rate improvement, appeal success, productivity, quality, and accuracy • Support special projects and revenue cycle improvement initiatives

🎯 Requirements

• Minimum 2 years of medical billing and collections experience (preferred) • Workers’ Compensation billing experience strongly preferred • Strong knowledge of EOB interpretation • Understanding of ICD-10 coding • Denial management experience • Proven experience with appeals and insurance carrier follow-up • Strong analytical and problem-solving skills • High attention to detail and ability to manage multiple accounts simultaneously • Excellent written and verbal communication skills • Proficient in Microsoft Excel • Ability to work independently in a fast-paced, growth-oriented environment • Experience billing medications/pharmacy-related services: 1 year (Preferred) • Workers’ compensation billing and claims: 1 year (Preferred)

🏖️ Benefits

• 401(k) • Dental insurance • Flexible spending account • Health insurance • Life insurance • Paid time off • Referral program • Vision insurance • Remote work arrangement • Monday-Friday schedule, 8:00am to 5:00pm

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