Reimbursement Specialist

Reimbursement Specialist

  • Anywhere

Admera Health, focuses on advanced molecular diagnostics, personalized medicine and non-invasive cancer testing. Our goal is to fulfill unmet medical needs with cost-effective tests and accurate analysis that guide patient care by utilizing next generation sequencing technologies and advanced bioinformatics to redefine disease screening, diagnosis, treatment, monitoring, and management. It is our mission to deliver transformative, valuable solutions for patients, physicians, payers, and clinical researchers.
Admera Health employees have a winning attitude and champion innovation, teamwork and accountability through a results-oriented, customer-centric, and fun culture. We offer various health and financial benefits, learning opportunities, competitive compensation, rewarding bonus programs, and a wide range of work/life benefits designed to make your life easier.
Admera Health is seeking a Reimbursement Specialist to join our innovative team.

Title: Reimbursement Specialist

Location: South Plainfield, NJ

Responsibilities:

  • Make sure every claim has an accession number
  • Verify that diagnosis codes are entered during accession in the correct relevant order
  • Perform eligibility verification
  • Claim Status through Navinet
  • Gather necessary info from Doctor’s offices and patients
  • Interact with Insurance Carriers for follow up
  • Inquire about Overpayment requests
  • Initiate Redetermination, fax them and scan into patient’s chart
  • Initiate Reconsideration process
  • Gather needed information for billing company
  • Process scanning of EOBs
  • Process request of additional information from Carriers
  • Reprocessing of claims over the phone

Qualifications:

  • Highly proficient in Microsoft Office, specifically Excel
  • Excellent verbal and written communication skills
  • Extremely organized and able to prioritize tasks effectively
  • Ability to work independently
  • Demonstrate excellent team skills, positive attitude and high ethical standards.
  • Medical Billing Program certificate
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