Reimbursement Specialist

Advanced Rx Management is a Pharmaceutical Services Company headquartered in Sunrise, Florida with team members throughout the United States. We provide physicians with the ability to provide their patients fast and convenient access to medications directly from the physician office or by mail. Our services directly impact patient convenience, care, and well-being at their personal physician’s office. The Company is experiencing rapid growth as it expands its product offerings and customer base throughout the United States.

Advanced Rx Management is seeking an experienced Medical Billing and Collections Specialist. This person needs to be a positive individual who enjoys working with a team and sees excellence as a priority. We are looking for an individual with an excellent understanding of insurance billing/collections processes: EOBs & ICD-10. Medical billing experience is mandatory. Candidate must also have an understanding and working knowledge of the appeals and denials process with health insurance carriers. Individual must be organized and possess excellent communication skills, interpersonal and problem-solving skills.

Job Responsibilities:

• Billing and Collections of Worker's Compensation and Personal Injury prescription claims


• Working aging reports and identifying claims that require appeal


• Timely follow up and tracking of any unpaid bills+ Underpaid bills


• Dissect and investigate the reason for a notice of disallowance or payment adjustments to secure proper


• reimbursement.


• ensures all necessary medical documentation are complete to appeal dispute of payments.


• Follow up with insurance companies and attorneys as necessary


• Review claims for errors and correct demographic information, insurance information, diagnosis codes or CPT codes, as necessary


• Maintaining a book of business, evaluating and appealing denied claims, and recording state disputes.


• Communicate professionally and effectively with insurance companies, staff and clinical personnel.


• Assist with special projects as needed

Qualifications:

• Minimum of 2 years of medical billing experience


• Worker's comp billing experience preferred


• Strong knowledge of billing and collection practices


• Excellent customer service and telephone etiquette


• Experience working with confidential medical information


• Strong research and problem-solving skills; attentive to details


• Able to work independently and performs multiple tasks effectively


• Excellent oral, written and interpersonal skills


• Strong knowledge of Microsoft Excel preferred


• Must be self-directed, able to work independently, as well as work in a team-oriented and fast paced environment

Schedule:

Mon-Fri 8:00am to 5:00pm On-site