Medical Reimbursement Specialist

Work Location:  Miramar, FL – (100% On-Site Required: No Remote or Hybrid) 

Schedule:  Full-Time, Monday – Friday

Pay Rate:  $19.00/Hour

ESSENTIAL DUTIES AND RESPONSIBILITIES: 

• Submit medical claims to appropriate payer.
• Ensure resubmission of claims, when applicable, are accurate.
• Ensure reimbursement of claims by submitted the most appropriate coding for services performed.
• ICD diagnosis coding, modifier application and verification of CPT and/or HCPCS codes.
• Responsible for ensuring all claims processed through Emdeon (Change Healthcare) are correct and compliant.
• Responsible for performing payer enrollment follow up·
• Keeps abreast of and comply with coding guidelines and reimbursement reporting requirements.
• Daily review and follow up on all incomplete electronic provider-billing encounters.
• Identify issues, correct code and/or pend due to missing information.
• Keep up to date on medical insurance rules and proper filing guideline.
• Answer patient calls/questions, clinic staff calls, and insurance company calls.
• Maintain a professional relationship with insurance companies and patients.
• Other duties as assigned.

QUALIFICATIONS AND REQUIREMENTS

• Minimum 3 years of experience of medical ICD & CPT coding experience preferred.
• Electronic Medical Record experience, Emdeon (Change Healthcare) software highly preferred.
• Proficient with Microsoft Office Suite.
• Excellent verbal and written communication skills.
• Excellent organizational and time management skills.
• Analytical, problem solving, and critical thinking skills.
• Ability to organize, coordinate, prioritize, and facilitate on-going tasks.
• Ability to work independently and with a team.

EDUCATION

• High School Diploma or equivalent required.
• Medical Billing/Coder Certification from accredited entity.

PHYSICAL DEMANDS
Requires sitting, standing, and occasional light lifting.

The Perks of Joining Our Team:

We believe in taking care of our team.  You'll enjoy a comprehensive benefits package designed to support your well-being and financial future:

• Comprehensive Health Benefits: Medical, Dental, Vision, Short-Term/Long-Term Disability Insurance, Life insurance.
• Time to Recharge: Paid vacation and holiday pay.
• Focus on Your Wellness: We offer a robust Employee Wellness Program.
• Invest in Your Future: 401(k) with a company match.
• Support System: Employee Assistance Program provides confidential support and counseling.
• Get Rewarded for Referring Great People:  Employee referral program.

Ready to start your rewarding journey with us? Apply today!

Please note while this job description is a comprehensive overview, additional responsibilities may be part of the role.

ProCare Rx will never ask for a financial commitment from an applicant as part of our recruitment process. All interviews are conducted in-person OR through video conference invitations from official company emails. For inquiries, please contact our recruitment team at HR@procarerx.com. 

ProCare Rx is an Equal Opportunity Employer.