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Reimbursement Associate

Company: Tides Medical
Location: Lafayette
Posted on: December 3, 2019

Job Description:

The Reimbursement Associate is responsible for all aspects of the insurance verification and prior authorization processes for applicable Tides Medical products. This is a front line position in a fast paced, results driven environment. The reimbursement associate responds to all provider and internal requests in a timely fashion and is responsible for providing patient specific coding, coverage, and reimbursement information to the company's customers. ROLES AND RESPONSIBILITIES Initiates and coordinates the insurance verification and prior authorization processes for physician office customers Performs a detailed insurance verification for product/procedure Relays coordination of benefits between primary and secondary insurers Answers technical reimbursement questions for providers, billing and coding staff, and sales representatives Accurately records all reimbursement correspondence and research in the database per the assigned fields and required metrics Analyzes data and draws valid and logical conclusions based on information provided by insurers and documented medical policies Communicates insurance verification and prior authorization results to customers and answers all related questions Researches customer questions as necessary and communicates with appropriate members of the team to ensure customers receive the highest level of customer service Prioritizes duties and tasks as necessary to ensure assignments are completed in a timely fashion Ensures continuous quality improvement and customer service by proactively identifying areas of improvement and communicating those ideas to the management team Coordinates responses and resolutions to issues with appropriate internal and external parties Maintains and promotes positive and professional working relationships with associates and management Performs related duties as assigned QUALIFICATIONS/EXPERIENCE Two or four year college degree (preferred but not required) Coding certification and/or training Coding and billing experience in the office, hospital, or ASC settings Experience in a reimbursement based call center environment 2-5 years customer service, reimbursement experience preferred Knowledge of Medicare, Medicaid, and private payer reimbursement methodology Able to interpret and analyze detailed medical policies Basic understanding of the benefits investigation process (deductible, out of pocket, benefits exclusions, etc.) Experience with the prior authorization process for products/services Ability to communicate effectively both orally and in writing Adept at handling sensitive and confidential situations Strong interpersonal skills Strong analytical skills Strong organizational skills; attention to detail Ability to resolve associate issues quickly and efficiently Ability to represent a positive and professional image Strong knowledge of Microsoft Word, Excel, Power Point and Outlook

Keywords: Tides Medical, Lafayette , Reimbursement Associate, Other , Lafayette, Louisiana

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