Artech Information Systems, LLC Reimbursement Counselor in United States

Reference # : 16-49025 Title : Reimbursement Counselor

Position Type : Contract Experience Level : Start Date / End Date : 10/31/2016 / 01/28/2017

Description Job Title: Benefit Investigation

Job ID: ABCXJP00007434

Location: Rockville, MD

Duration: 03+ Months (Possible temp - perm for the right candidate)

Working hours: 10:30 A.M -7 P.M. And 11:30 A.M. -8 .00 P.M.

Training Hours: Training for both shifts will be conducted between 8:30 - 5:00 p.m.


  • Must have recently Health Insurance background

  • Must be proficient in Word and Excel

  • Will be the single point of contact with speaking with the Patients, Doctors and Sales Rep.

  • Must have strong organization skill

  • Must be detailed.

  • Must be Sympathetic and Empathetic especially when speaking with the patients on the phone.

  • Excellent Communication Skills

  • Will be calling Insurance Companies and obtaining coverage for specific medications

  • Heavy Phones and interaction

Ideal candidate would be someone that has recent experience working in a Doctor’s office working with Health Insurance

Primary Duties and Responsibilities:

  • Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved.

  • Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.

  • Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.

  • Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors.

  • Researches and resolves any electronic claim denials.

  • Researches and resolves any claim denials or underpayment of claims.

  • Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods.

  • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.

  • Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.

  • Reports any reimbursement trends/delays to supervisor (e.g. billing denials, claim denials, pricing errors, payments, etc.).

  • Processes any necessary insurance/patient correspondence.

  • Provides all necessary documentation required to expedite payments.

  • This includes demographic, authorization/referrals, National Provider Identification (NPI) number, and referring physicians.

  • Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process.

  • Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation.

  • Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims.

  • Works on problems of moderate scope where analysis of data requires a review of a variety of factors.

  • Exercises judgment within defined standard operating procedures to determine appropriate action.

  • Typically receives little instruction on day-to-day work, general instructions on new assignments. Performs related duties as assigned.

  • Ability to communicate effectively both orally and in writing.

  • Ability to build productive internal/external working relationships. Strong interpersonal skills.

  • Strong negotiating skills.

  • Strong mathematical skills.

  • Strong organizational skills; attention to detail.

  • General knowledge of accounting principles, pharmacy operations, and medical claims.

  • General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred. Global understanding of commercial and government payers preferred.

  • Ability to proficiently use Microsoft Excel, Outlook and Word.

  • Is developing professional expertise; applies company policies and procedures to resolve a variety of issues.

Thanks and Regards,

Avinash. M

Associate Recruiter

Artech Information Systems LLC

360 Mt. Kemble Avenue, Suite 2000 | Morristown, NJ 07960

Office: 973.967.7538 | Fax: 973.998.2599

Email: | Website: