Reimbursement Specialist - Collector

Company Description

Lingraphica is a mission-driven organization who provides speech-generating devices to help improve communication, speech, and quality of life for people with communication impairments. We look for candidates who enjoy working in a fast-paced, goal-oriented environment, and who share our commitment to helping individuals on their communication journey.

Job Description

Purpose: The Reimbursement Specialist – Collector is responsible for ensuring the timely and accurate follow-up on all claims, maintaining effective communication with payors, patients, and caregivers as necessary. This role also involves cross-training with team members to provide support in additional billing and payment posting functions as required. 

Essential Duties & Responsibilities: 

• Manage the collection of outstanding balances from both insurance companies and patients 
• Conduct timely follow-up on all submitted claims to ensure prompt resolution 
• Review and correct rejected claims as necessary, ensuring accurate and timely resubmission to maximize reimbursement 
• Identify, document, and address claims/billing errors, denials, and rejections 
• Analyze claim denials and rejections to identify root causes and implement strategies to prevent future occurrences 
• Collaborate with internal departments to address systemic issues leading to denials 
• Appeal denied and short-paid claims to maximize reimbursement
• Establish and manage patient payment plans as necessary 
• Initiate contact with customers and insurance companies via phone or mail to facilitate payments and resolve account issues 
• Monitor and manage Accounts Receivable
• Assist in the preparation of documentation for audits and ensure adherence to regulatory requirements 
• Maintain up-to-date knowledge of insurance policies, billing regulations, and compliance standards 
• Uphold confidentiality and adhere to HIPAA standards for handling Protected Health Information (PHI) 
• Perform additional duties as assigned to support the overall function of the reimbursement department 

Qualifications

Knowledge, Skills & Abilities 

• Attention to detail, organization and problem-solving skills, persistence, and flexibility 
• Knowledge of Medicare, Medicaid and Commercial regulations 
• Computer skills including use of Excel, Outlook, preferred 
• Exposure to HubSpot or other CRM, preferred 
• Excellent and effective communication 
• Ability to effectively handle multiple and shifting priorities 

Education & Experience 

• High School Diploma or equivalent, required
• 1 – 3 years in medical reimbursement and DME experience, preferred
• Exposure to billing and collections, preferred
• Experience using medical billing software such as ADSC, preferred

Additional Information

Work Environment & Physical Demands

Incumbent works from home and is expected to maintain a safe, productive work environment with secure internet access. The ability to operate a computer with or without reasonable accommodation is required.

Travel

Travel is required for the annual company meeting and team off-site, within the continental United States, approximately twice per year. 

Accommodations

To perform this job successfully, an individual must be able to perform each essential duty and physical demand satisfactorily. The requirements listed above are representative of the knowledge, skills, and/or abilities and physical demands required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

To learn more about Lingraphica, visit: www.lingraphica.com!

This Organization Participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. 

Este empleador participa en E-Verify y proporcionará al gobierno federal la información de su Formulario I-9 para confirmar que usted está autorizado para trabajar en los EE. UU.