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Reimbursement Hotline Specialist
PRIA Healthcare
Torrington, CT, USA
Posted on Nov 14, 2024
The Reimbursement Hotline Specialist will be a critical member of PRIA’s operations team, reporting directly to Sr. Leadership in Operations. This full-time, remote (or hybrid if local to CT) role will be responsible for managing Reimbursement and patient support hotlines for PRIAs clients, answering billing and coding and general reimbursement and policy questions. The role will also include proactive education to clients and provider offices and facilities on reimbursement topics, including temporary payment methodologies, specifically, New Technology Add on Payments (NTAP) and Transitional Pass-Through Payments (TPT).
Key Responsibilities:
- Utilize knowledge in health care reimbursement systems to be a resource to colleagues and clients.
- Stay abreast of key coding, policy and payment changes.
- Manage and interacts with clients with minimal supervision.
- Stay abreast of key reimbursement and market access policy issues impacting clients.
- Own responsibility for the quality of deliverables.
- Manage client’s billing and coding Hotlines, including being involved in Development and Implementation and ongoing operations. Specific tasks include: proactively or reactively answering billing and coding questions from physician providers, facilities field-facing staff and other stakeholders.
- Upon request, additional duties, including support as a customer service representative and coding analyses for specific projects.
Required Qualifications:
- College degree preferred but will substitute for applicable work experience
- Must be a certified coder, with updated certifications.
- Ideally in physician, hospital outpatient and inpatient coding,
- Should have billing experience in the hospital setting and preferably in hospital and physician setting
- 5+ years of experience in reimbursement, market access, or a similar background in the MedTech industry or consulting is required for this position.
- Superior oral and written communication skills.
- Must have the ability to guide providers on complex coding and billing issues/scenarios and also be able to troubleshoot.
- Strong intellectual curiosity and a desire to develop an in-depth understanding of systems, business processes, and complex issues.
- Ability to read, analyze, and interpret complex documents.
- Knowledge of medical, anatomical, and physiological terminology preferred.
- Proficiency with Microsoft Office (Word, PowerPoint, Excel) and internet applications.
- Strong professionalism with customer relationships.
- Self-directed and proactive attitude with the ability to identify key processes and new services needed by clients.
Compensation & Benefits:
- Competitive compensation package
- Generous Paid Time Off
- Comprehensive Medical/Dental/Vision plan
- 401K with 3% match
- Tuition Reimbursement Program
- Generous Employee Referral Program
- Rewards & Recognition Platform
- Professional development opportunities
- Employee health & wellness programs
- Coding certification reimbursement
NOTE: This job description is not intended to be all-inclusive. Employee may perform other related duties as to meet the ongoing needs of the organization.