Reimbursement Specialist

🔥 16 minutes ago

🇺🇸 United States – Remote

💵 $23 - $25 / hour

⏰ Full Time

🟢 Junior

🟡 Mid-level

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Tandem Diabetes Care

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

🔧 Hardware

☁️ SaaS

👥 B2C

Hardware • SaaS • B2C

Tandem Diabetes Care is a medical device company that designs and manufactures insulin pumps and automated insulin delivery systems powered by its Control-IQ+ predictive algorithm. Its products, including the t:slim X2 and Tandem Mobi, integrate with continuous glucose monitors and compatible smartphones, support remote software updates, and are accompanied by mobile and cloud-based applications, training, and 24/7 support to help people manage insulin therapy.

📋 Description

• Assure all insurance claims are processed timely, accurately, and efficiently • Secure payments from both contracted and non-contracted insurance entities as well as customers • Work closely with Customer Sales Support to assure data accuracy and communication of requirements from health insurance plans • Review medical criteria to assure patient documentation meets standards • Carefully review all patient related data and documentation for accuracy prior to claim submission • Create and submit healthcare claims to insurance companies • Communicate with patients to advise on status of insurance claims, as necessary • Contact patients regarding collection of outstanding invoices • Field inbound calls from patients regarding inquiries related to insurance claims • Make outbound investigational calls to insurance providers to determine status of outstanding claims • Negotiate structured payment plans • Access CRM to receive and provide up to date patient claim information • Keep up to date with specifications on all of Tandem products and services • Confirm completion of required training plan before assuming job responsibilities • Ensure work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements

🎯 Requirements

• BA/BS or equivalent combination of education and applicable job experience • 2+ years experience in medical billing or equivalent experience • Experience in a HIPAA controlled environment is required • Experience billing durable medical equipment is preferred • Experience in diabetes or other disease management device/diagnostics is preferred • Understanding of medical billing, insurance claim processing, and follow up procedures • Understanding of all data required on a Health Care Financing Administration (HCFA) 1500 billing form • Knowledge of billing codes and modifiers assigned by the Centers for Medicare and Medicaid Services (CMS) • Ability to understand Explanation of Benefits provided by heath care providers • Knowledge of claims clearing houses and the basic functionality of these services • Demonstrated ability to effectively communicate over the phone with customers and insurance companies to resolve clear-cut issues and answer questions according to department protocols and requirements • Able to effectively share information related to work product in verbal and written form • Able to contribute to the team by supporting the acceptance of new team members • Demonstrated ability to work accurately, to follow instructions and schedules, and handle multiple priorities • Experience with MS Office suite (Word, Excel, and Outlook), Internet, & customer relationship management systems (CRM)

🏖️ Benefits

• health care benefits such as medical, dental, vision available your first day • health savings accounts and flexible saving accounts • 11 paid holidays per year • a minimum of 20 days of paid time off (with accrual starting on day 1) • access to a 401k plan with company match • Employee Stock Purchase plan