Mediware Reimbursement Coordinator in Andover, Massachusetts

Job Description:

Are you interested in changing the world of healthcare and human services? Do you want to work with innovative web and mobile software applications with great impact on society? Can you provide smart ideas and experiments about what’s possible? Do you work hard to help others to achieve their best results? Do you want to be amazed, inspired and proud of your job every day? Come and show us what you’re made of.

Mediware Information Systems, Inc. is a fast growing Top 100 Healthcare Software company. We design and build products that are inspiring and make a real impact in people’s lives. We have 600+ employees across the US, UK and Netherlands. Mediware’s portfolio of solutions currently includes long-term services and supports, behavioral health, blood solutions, cellular therapy, home care, medication management, rehabilitation and respiratory therapy.

The Reimbursement Coordinator generates Home Infusion and Durable Medical Equipment (DME) claims for submissions to patients and/or third party payers (including billing for commercial and federal/state government sponsored programs; facility billing; and any other billing as assigned) in order for the bill to be paid. These claims result from products and services delivered to or administered to patients on behalf of our customers. Perform collection follow up on primary and secondary claims as well as patient balances as assigned using the techniques outlined in the ‘Guidelines for Success’ document.

Principal Functions of the Job

Billing related tasks:

  • Obtain billing information from Customers on a daily basis to generate claims.

  • Perform Q.A. of charges received from the Customers and make modifications/changes as required to produce a clean claim

  • Review contract/details of new payers before billing. Work with supervisor/manager on changes needed in the billing system (ie: HomecareNet™).

  • Track pending claims.

  • Submit claims to insurance companies in a timely fashion and within the individual insurance company’s timely filing period.

  • Prepare and/or print all secondary claims that do not automatically cross over from Medicare or other primary payer

Collection Related tasks:

  • Follow up on patient balances within established timeframes.

  • Obtain claim’s status by calling the payer and/or using an on-line claims status system such as Navinet.

  • Utilize reports (such as those generated from Rockpond) to determine tasks that require follow up.

  • Take appropriate action for escalating claims not paid within 60 days or for denied appeals.

  • Prepare write-off form when bad debt is identified. Document description of the reason for the write-off.

  • Research claim payments, partial payments, over payments.

  • Prioritize claims to identify Top Ten accounts. Keep accounts current until complete. Prepare report of Top Ten accounts monthly for supervisor/manager review.

  • Prepare status report with supporting documentation of all claims over 90/120 days.

Job Qualifications:

Required Education and/or Experience

  • High school diploma required.

  • Medical billing certification or some college education is preferred.

  • Minimum of 2 years work experience required in: healthcare billing and/or collection or healthcare insurance claims processing experience. Home IV related experience a plus.

  • Data entry experience, computer skills, Microsoft Office, Word, and Excel is desirable.

  • Must have good attention to detail and accuracy

  • Strong organizational skills and ability to follow through

  • Good problem solving sills

  • Math aptitude

  • Ability to deal with the public in a positive and professional manner

  • Good verbal and written communication skills

  • Exhibit excellent work ethic and commitment to job responsibilities

  • Works well in a team environment

We're looking for talented individuals who want to use their skills to build a strong, technology-driven company. We offer competitive salaries, great benefits, and a casual and fun environment that encourages quality, creativity and excellence. Enjoy all we have to offer. We invite you to join us. Apply today!

Mediware provides equal employment opportunities to all people without regard to race, color, religion, sex, national origin, ancestry, marital status, veteran status, age, disability, sexual orientation or gender identity or expression or any other legally protected category.

Job Title: Reimbursement Coordinator

Location: Andover, MA

Full/Part Time: Full

Req: FR-11

Department: Reimbursement