Customer Reimbursement Coordinator

Overview: The Customer Reimbursement Coordinator is responsible for providing direct assistance to customers with their reimbursement inquiries and claims. This role involves verifying insurance benefits, assisting with claims processing, initiating prior authorizations with payers on behalf of providers, answering customer queries, and ensuring compliance with reimbursement policies and regulations. The ideal candidate will have strong communication skills, a detail-oriented mindset, and experience in customer service or healthcare reimbursement.

Responsibilities:

• Respond to customer inquiries regarding reimbursement policies, claims status, and procedures via phone, email, and other communication channels
• Provide clear and accurate information to customers about the reimbursement process
• Provide appeal and denial support for negative outcome authorization requests
• Assist customers in completing and submitting reimbursement claims
• Review and verify benefits in accordance with company policies and regulatory requirements
• Verify the accuracy and completeness of claim documentation
• Ensure timely and efficient assistance with the processing of claims to meet customer needs and company standards
• Maintain detailed and organized records of customer interactions and claims processing
• Ensure all documentation is accurate, up-to-date, and compliant with relevant regulations
• Prepare and submit reports on reimbursement activities and trends as required
• Adhere to all relevant regulations, policies, and procedures related to reimbursement
• Conduct regular quality checks to ensure high standards of service and compliance
• Stay informed about changes in reimbursement policies and procedures and update customers and internal teams accordingly
• Work closely with other departments to resolve complex reimbursement issues and improve processes
• Provide support and assistance to team members as needed
• Participate in training and development activities to enhance knowledge and skills

Skills/Qualifications:

• Associate's degree in business, healthcare administration, or a related field or equivalent work experience is required, a bachelor's degree is preferred
• Minimum of 4 years of experience in customer service, healthcare reimbursement, or a related field
• Strong understanding of reimbursement processes and regulations
• Excellent communication and interpersonal skills
• High level of attention to detail and accuracy
• Proficiency in using customer support software and office applications
• Experience with reimbursement management systems and software
• Knowledge of healthcare insurance and billing processes
• Certification in healthcare reimbursement or a related field

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