Top 130 Reimbursement specialist i Jobs in Temecula, Ca

Reimbursement Specialist I
FFF Enterprises —Temecula, CA
- Customer service
- HIPAA
- Office
- Health insurance
HR Generalist-Leave of Absence (LOA) Specialist-(TEMPORARY)
Southwest Healthcare System —Temecula, CA
- $30.46 - $44.16 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Driver's License
- Continuing education credits
- Disability insurance
Youth Restoration Specialist
SAFE Family Justice Centers —Temecula, CA
- $24.00 - $33.60 an hour
- Full-time
- Spanish
- Mid-level
- Driver's License
- Mileage reimbursement
- Health insurance
Quick Apply
Specialist: Seasonal, Part-time
Apple —Temecula, CA
- $24.00 - $30.59 an hour
- Part-time
- Entry level
- Employee stock purchase plan
- Health insurance
HR Support Services Assistant
Southwest Healthcare System —Temecula, CA
- $23.00 - $34.32 an hour
- Full-time
- Mid-level
- High school diploma or GED
- Business Administration
- Continuing education credits
- Loan repayment program
Speech Language Pathologist (SLP) | Relocation $10,000 | Ventura County
Amigo Baby. Inc —California
- From $130,000 a year
- Part-time
- Spanish
- CPR Certification
- Current TB test
- Mileage reimbursement
- Health savings account
Quick Apply
Behavior Technician (Bachelor's Degree Required)
Coyne and Associates —Murrieta, CA
- $21 - $27 an hour
- Full-time
- Driving
- Psychology
- Mentoring
- Paid training
- Mileage reimbursement
Quick Apply
1d
Pediatric Occupational Therapist (OTR/L) | Relocation $10,000 | Ventura County
Amigo Baby. Inc —California
- From $130,000 a year
- Part-time
- Spanish
- CPR Certification
- Current TB test
- Paid training
- Mileage reimbursement
Quick Apply
Senior Associate Attorney - Family Law
Confidential —California
- $220,000 - $320,000 a year
- Full-time
- Remote
- US work authorization
- Organizational skills
- Senior level
- Profit sharing
- Paid holidays
Quick Apply
Early Intervention Specialist, Senior – Infant Development Services (Part-Time)
Radiant Kids Therapy —Oceanside, CA
- $30 - $32 an hour
- Part-time
- 3 years
- Driver's License
- Education
- Mileage reimbursement
- Health insurance
Quick Apply
10d
Behavior Technician - Early Childhood Instructor
Coyne and Associates —San Marcos, CA
- Up to $27 an hour
- Full-time
- Driving
- Mentoring
- Teaching
- Travel reimbursement
- Paid training
Quick Apply
4d
Regulatory Compliance Specialist
Related —California
- $75,000 - $90,000 a year
- Full-time
- 5 years
- Mid-level
- Real Estate License
- Health savings account
- AD&D insurance
Clinical Sales Specialist, Interventional Pain - Bay Area, CA
Avanos Medical —California
- $80,000 - $95,000 a year
- Full-time
- Remote
- Marketing
- Word processing
- Mid-level
- Health insurance
- 401(k) matching
PTs, SLPs & OTs (In-Home with Kids)
Radiant Kids Therapy —San Marcos, CA
- $82,000 - $105,000 a year
- Part-time
- 18 years or older
- Spanish
- Mid-level
- Continuing education credits
- Mileage reimbursement
Quick Apply
10d
Environmental Specialist I/II
City of Vista, CA —Vista, CA
- $75,183.16 - $100,752.86 a year
- Overtime
- Word processing
- Pass drug screening
- Research
- Health insurance
- Dental insurance
1d
Resident Service Specialist - Luxury Apartment Community
UDR, Inc. —Menifee, CA
- $27 - $30 an hour
- Word processing
- Residential
- High school diploma or GED
- AD&D insurance
- Disability insurance
Quick Apply
Family Specialist - Wraparound (Part-time)
Koinonia Family Services —Temecula, CA
- $20 - $22 an hour
- Part-time
- Current TB test
- High school diploma or GED
- Driver's License
- Mileage reimbursement
- Paid holidays
Quick Apply
Accounting Specialist
The Happier Life Project —Lake Elsinore, CA
- $32 - $38 an hour
- Full-time
- Hybrid work
- Mid-level
- Office
- 3 years
Early Education Specialist
ABC Interventions Inc. —Temecula, CA
- $23 - $28 an hour
- Choose your own hours
- Bilingual
- HIPAA
- Driver's License
- Paid training
- Mileage reimbursement
Quick Apply
Pre-Arrival Specialist
Hyatt Vacation Club at The Welk —Escondido, CA
- $25 an hour
- Part-time
- Ability to walk for extended periods
- Pass drug screening
- Ability to sit for extended periods
- Free parking
- Health insurance
5d

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Reimbursement Specialist I

FFF Enterprises -
Temecula, CA

Apply Now

Job Details

Benefits

Health insurance

Qualifications

HIPAA compliance
Customer service
HIPAA
High school diploma or GED
Productivity software
Clinical confidentiality policies

Full Job Description

Position Summary

The Reimbursement Specialist is a pivotal position requiring excellent communication skills, independent judgment, and ability to interact with private, state and federal payer representatives, fiscal intermediaries, case managers, pharmacy partners and nufactor field personnel in the role of coordinating reimbursement from product dispensing through to completion and final resolution of the payment cycle.

Incumbent shall possess basic knowledge of reimbursement principles as well as the structure of various private, federal and state payer entities and the specific program issues related to each.

Essential Functions and Duties

Submit and/or follow-up on payer claims. This may include; primary, secondary, tertiary claims and/or patient statements. Verify accuracy of payments according to the payer’s fee schedule.

Possess a basic understanding and ability to audit accounts receivables: analysis of payments, contractual discounts and/or adjustments, bad debt, recoupments, refunds and the credit/debit function.

Draft professional, concise cover letters, appeals and correspondence. This may include provider dispute forms, re-openings, reconsiderations, and various levels of appeals as necessary during the collection process.

Resolution of credit balances. This may include revenue adjustments, balance transfers, recoupments and/or refunds.

Clearly and accurately document all collection efforts within the AR system. Complete and submit monthly claim status reports.

Promptly inform management of reimbursement rates, changes, and/or issues which may directly affect nufactor receivables.

Maintain reimbursement records in compliance with nufactor policies & procedures.

Attend and participate in departmental meetings. Continuously strive to improve processes and service quality to internal and external customers.

Attend pertinent job-related trainings and educational seminars.

Conduct special projects as requested by management.

Supports all reimbursement activities related to a revenue base representing approximately $200 million per year and a projected DSO of less than 40 days.

Adheres specifically to all company policies and procedures, Federal and State regulations and laws.

Display dedication to position responsibilities and achieve assigned goals and objectives.

Represent the Company in a professional manner and appearance at all times.

Understand and internalize the Company’s purpose; Display loyalty to the Company and its organizational values.

Display enthusiasm and dedication to learning how to be more effective on the job and share knowledge with others.

Work effectively with co-workers, internal and external customers and others by sharing ideas in a constructive and positive manner; listen to and objectively consider ideas and suggestions from others; keep commitments; keep others informed of work progress, timetables, and issues; address problems and issues constructively to find mutually acceptable and practical business solutions; address others by name, title, or other respectful identifier, and; respect the diversity of our work force in actions, words, and deeds.

Comply with the policies and procedures stated in the Injury and Illness Prevention Program by always working in a safe manner and immediately reporting any injury, safety hazard, or program violation.

Ensure conduct is consistent with all Compliance Program Policies and procedures when engaging in any activity on behalf of the company. Immediately report any concerns or violations.

Other duties as assigned.

Education, Knowledge, Skills and Experience

Required Education:
High school diploma or equivalent required.

Required Knowledge:
Basic knowledge medical reimbursement principles.

Intermediate to advanced Microsoft Office skills. Basic to intermediate understanding of Internet technologies, including payer portals.

Required Experience:
Three (3) years health care related experience i.e. DME, home care, medical insurance, or medical case management.

Preferred Experience:
Pharmacy or home infusion experience preferred.

Required Skills:
Excellent verbal and written communication skills, along with the ability to interact effectively with customers, coworkers, and all levels of management.

Ability to effectively communicate with all levels of personnel within the payer realm, including proficiency in accessing the appropriate personnel to resolve problem claims.

Ability to make independent judgments and work with minimal supervision.

Strong organizational skills and detail oriented with the ability to manage multiple assignments and responsibilities. Ability to prioritize work, work effectively, and maintain expected productivity.

Ability to exercise discretion and maintain confidentiality to the level of required HIPAA standards.

Physical requirements

Vision, hearing, speech, movements requiring the use of wrists, hands and/or fingers. Must have the ability to view a computer screen for long periods and the ability to sit for extended periods. Must have the ability to work the hours and days required to complete the essential functions of the position, as scheduled. Must have the ability to lift and maneuver items of at least 20 lbs. Working condition include normal office setting.

Mental Demands

Learning, thinking, concentration and the ability to work under pressure, particularly during busy times. Must be able to pay close attention to detail and be able to work as a member of a team to ensure excellent customer service. Must have the ability to interact effectively with co-workers and customers, and exercise self-control and diplomacy in customer and employee relations’ situations. Must have the ability to exercise discretion as well as appropriate judgments when necessary. Must be proactive in finding solutions

Direct Reports

No

EEO Statement

FFF Enterprises and Nufactor are an equal opportunity employer and prohibits discrimination and harassment based on the following characteristics: race, color, religion, national origin, physical or mental disability, gender, age (40 years and over) qualified veteran and any other characteristic protected by state or federal anti-discrimination law covering employment. These categories are defined according to Government Code section 12920. The Company prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has or is perceived as having any of those characteristics.

Apply Now

Refine Your Search

reimbursement specialist i jobs in temecula, ca

Reimbursement Specialist I

HR Generalist-Leave of Absence (LOA) Specialist-(TEMPORARY)

Youth Restoration Specialist

Specialist: Seasonal, Part-time

HR Support Services Assistant

Speech Language Pathologist (SLP) | Relocation $10,000 | Ventura County

Behavior Technician (Bachelor's Degree Required)

Pediatric Occupational Therapist (OTR/L) | Relocation $10,000 | Ventura County

Senior Associate Attorney - Family Law

Early Intervention Specialist, Senior – Infant Development Services (Part-Time)

Behavior Technician - Early Childhood Instructor

Regulatory Compliance Specialist

Clinical Sales Specialist, Interventional Pain - Bay Area, CA

PTs, SLPs & OTs (In-Home with Kids)

Environmental Specialist I/II

Resident Service Specialist - Luxury Apartment Community

Family Specialist - Wraparound (Part-time)

Accounting Specialist

Early Education Specialist

Pre-Arrival Specialist

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