Reimbursement Program Specialist

Reimbursement Program Specialist Shield HealthCare - 3.0 Valencia, CA Job Details Full-time $23 - $27 an hour 17 hours ago Benefits Disability insurance Health insurance Dental insurance Flexible spending account Vision insurance 401(k) matching Referral program Qualifications Customer communication Microsoft Excel Legal analysis Medical coding Health insurance policy knowledge HIPAA Microsoft Teams SharePoint Productivity software Clinical confidentiality policies Medical billing regulations compliance Medical terminology Technical Proficiency Full Job Description Since 1957, Shield Healthcare has provided high-quality healthcare services while focusing on customer satisfaction and employee achievement. We are dedicated to fulfilling the medical supply needs of consumers and the caregiving community while maintaining a 99% overall customer satisfaction rating. Over the years, Shield HealthCare has expanded nationally with current service locations in California, Colorado, Illinois, Ohio, Texas and Washington. Shield HealthCare is looking for a Reimbursement Program Specialist in Valencia, CA responsible for implementing internal processes and controls that ensure compliance with new and existing regulatory requirements for the distribution of durable and disposable medical equipment and supplies. The Reimbursement Programs Specialist ensures the organization is paid correctly, reduces claim denials, and helps patients access needed medical supplies. This role requires accurate and current knowledge of medical reimbursement rules, insurance policy changes, and various medical compliance regulations. This position is on-site in Valencia, CA.

JOB RESPONSIBILITIES

Partners with healthcare providers, government and advocacy agencies assigned to ensure proper program coverage and compliance Effectively maintains and communicates current company policies, procedures, and practices to ensure all departments have accurate, relevant information related to reimbursement programs Monitors regulatory agency policy changes to include research and communication of findings to internal stakeholders Assists in managing reimbursement related issues and policies/procedures, communicating trends and suggesting corrective actions to leadership Acts as a resource to the organization for payer knowledge and support Partners with internal departments to ensure customer orders are shipped and billed without reimbursement issues May act as a liaison between insurance companies, healthcare providers, and customers Additional projects supporting the reimbursement programs as assigned by the department leader

QUALIFICATIONS

3+ years working in a Reimbursement Programs position with knowledge of medical billing/coding and insurance reimbursement processes Bachelor's degree in healthcare administration, public health, business, organizational management, or equivalent experience in healthcare compliance Proficiency in Microsoft 365 (Excel, PowerPoint, Word, SharePoint, Teams) A thorough understanding of HIPAA regulations, requirements, and guidelines, familiar with the privacy and security rules and how they apply to healthcare Ability to read, analyze, and interpret technical journals, legal documents, medical terminology, and complex documents Skilled in fostering collaborative relationships across internal teams and with external partners Excellent written and verbal communication skills Strong organizational skills, with extreme attention to details, the ability to manage multiple priorities, projects, respond to changing business needs, and meet critical deadlines Strong analytical and problem-solving skills

Pay & BENEFITS:

$23-27/ hour Medical, Dental, and Vision 401(k) with Company Match Sick and Vacation Days Flexible Spending Account Life & Disability Insurance Education Assistance Employee Referral Program Career-minded individuals will find our business challenging and our reputation for excellence just one of the rewards we have to offer. To further enhance this tradition of excellence, our employees participate in continuous training and development programs in a variety of disciplines.