Reimbursement Specialist

Our employees have spoken! Our company culture is amazing, and our Great Place to Work Certification proves it. Would you like to work for a company where over 90% of employees feel respected, treated fairly, and where we showcase our commitment to diversity, equity, and inclusion? If so, come join our team. 

For over 25 years, Dominion Diagnostics has been committed to advancing patient care through trusted diagnostics. We are a premier urine drug testing/toxicology laboratory serving Addiction/ Substance Use Disorder Treatment, MAT + OTP Clinics, and Pain Management settings. Dominion Diagnostics currently has labs in over 30 states across the country.

Position Summary 

The Reimbursement Specialist will maximize collections from insurance payers through the resolution of payer denials, clearinghouse rejections, and payment errors. This position is a full-time, hybrid role based in North Kingstown, Rhode Island.

Principal Duties and Responsibilities:

• Resolve denials, rejections, and payment errors in a timely manner to maximize reimbursement
• Analyze denial trends and communicate payer, policy, and reimbursement changes to management to aid in forecasting cash collections
• Prepare and submit appeals and/or medical necessity documentation to payers 
• Provide excellent customer service to patients, clients, and payers
• Maintain productivity standards as established by management
• All other duties as assigned based on staffing or other initiatives, including, but not limited to, payment posting, demographic entry, cross-training, and overtime to ensure departmental goals are met and a team environment is maintained
• Must adhere to HIPAA and compliance requirements as set forth by payers and Dominion’s Compliance program.

Required Skills and Competencies:

• Advanced knowledge of Medicaid, Medicare, and Commercial insurance 
• Familiarity with payer Explanation of Benefits and Remittance Advice codes 
• Proficiency using technology and tools necessary to complete duties and responsibilities, including computer, phone, email, Microsoft Word, Excel, and Outlook 
• Maintain accuracy and speed when typing
• Excellent verbal and written communication skills
• Detail-oriented, displays a high level of accuracy 
• Analytical mindset with ability to identify trends and changes in payer/reimbursement behavior
• Strong organizational and time management skills
• Ability to work independently with minimal guidance while adhering to company standards and guidelines
• Approachable and promotes collaboration with team members, management, payers, patients, and clients to achieve results. 
• Contribution of new ideas for efficiency and improved processes
• Demonstrate consistent professionalism in appearance, demeanor, and interactions
• Experience with HIPAA standards and compliance programs

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Utilizing a telephone to communicate with internal and external customers.
• Attendance at in-person and virtual meetings
• Must be able to commute to the office in North Kingstown, RI

Hybrid Work Model:  

Employees are required to work in-office, at a minimum, one day per week for collaboration and in-person meetings.  The specific in-office day is at the manager’s discretion, may vary based on the needs of the business, and is subject to change, providing advanced notice.

Excellent Benefits:

Our comprehensive benefits package includes medical, dental, and vision coverage; a 401 (k) plan with an employer match, paid time off; employer-paid life and disability insurance with additional buy-up coverage options; tuition and continuing education reimbursement; and other voluntary benefits. In addition, an annual bonus may be paid to eligible employees based on organizational and individual performance. Employees and their family members have full access to our Employee Assistance Program, which includes resources for work/life solutions, such as one free legal consultation and referrals for emotional support/counseling.