Healthcare Reimbursement Specialist: ATR International, Inc.

ATR Professional, a division of ATR International, has been a leader in the staffing industry since 1988, placing professionals in the industry's most innovative companies. We currently have an exciting opportunity for a Healthcare Reimbursement Specialist with one of our important clients.

Position Information:
Job Title: Healthcare Reimbursement Specialist
Location: South San Francisco, CA
Duration: 6 months
Compensation: DOE $/hour

Job description:

We are looking for someone to investigates patient's insurance benefits. Identifies network providers, provider restrictions, co-pays as needed. Documents requirements for prior authorization and medical review process. Documents activities appropriately in progress notes. Pursue product coverage for patients in accordance with the payor's authorization requirements within the departments established performance criteria. Create written communication to customers regarding reimbursement status. Maintains payor profiles by recording payor specific data promptly into the system. Consults with team members on an as needed basis. Collects and enters data for distributor referral cases.

Requirements:

The ideal candidate must possess a BA or BS degree, 3 years experience in Healthcare reimbursement required; verifying benefits, prior authorizations and working with public and private insurance. Must be able to drive for results. Proficient in all aspects of reimbursement (i.e. benefit investigation, payor reimbursement policies). Excellent investigational and analytical skills with a proven ability to communicate effectively in both written and verbal format. Ability to work collaboratively in a team structure and responsibly delegates next steps to appropriate team members. Demonstrates effective problem solving and excellent customer service. Exceptional attention to detail and ability to prioritize tasks. Requires computers skills including MS Excel.

MUST HAVE:

Medical Insurance payer knowledge - demonstrated in phrases: Benefit investigations/ verifications, prior authorizations, Insurance networks, Specialty Pharmacies, Pharmacy Benefit managers, Major Medical.

2+ years experience verifying medical benefits.

Evidence of experience verifying benefits with Private payers ( Aetna , Blue Cross/Shield, Well Point, etc.).

Evidence of experience working with Public payers (Medicare & Medicaid must be listed in resume).

Proficient computer skills.

Work in team environment.

NICE TO HAVE:

Experience with Medicare Part B & Medicare Part D specifically listed on resume.

Work at a reimbursement service company (Lash, Covance, McKesson, Health Connections, etc.).

Evidence of thorough knowledge of the public & private payer landscapes.

Work at or with a specialty pharmacy (Caremark, CuraScript, Option Care, Aetna SP, etc.).

To be considered for this position, please click the "Apply Now" button or contact the following recruiter directly:

Name: Lucille Aviles
Phone: 408-328-8009
Email: lucillea@atr1.com

Visit our website at www.myatr.com for an up-to-date listing of opportunities.