Apex Systems is looking to employ a Billing and Reimbursement Specialist in St. Louis, MO
If interested, please send an updated copy of your resume to email@example.com
- Candidates must have prior reimbursement experience either from a doctor's office or from working with insurance.
- Must know how to pull benefit investigations and report out.
- Need to have strong professional experience with strong written and verbal communication skills as will be talking to physician's office and insurance companies.
- Need to be comfortable working on the computer, will use an internal Outlook based system for this position.
- Training will last about 3 weeks.
- These positions could have potential for conversion to permanent roles for the right candidates based on performance and attendance.
Need to be available to work 8 am to 8 pm, M-F, shifts will be assigned after all hiring has been completed.
ATTENDANCE AND PUNCTUALITY ARE CRITCAL FOR THESE POSITONS
The primary goal of this position is to provide high quality customer service and effectively interface with patients, patient’s families, national payers, home cares and medical doctor’s offices to assist patient and medical provider in expediting the process starting the patient on client product and ensure the highest level of reimbursement is attained for client product.
1. Conduct benefit investigations, verify insurance benefits for patient and physicians’ office, and submit and obtain prior authorization as required by payer; obtain recertification for cases requiring extended treatment/coverage beyond the expiration of original approval. - 30 %
2. Accurately enter and maintain data as required in client database and patient files and utilize the client database to monitor outstanding items on each client case file. Ensure files are complete so team can determine the current status.-20 %
3. Participate in conference calls with Client Sales Representatives, client management and physicians’ offices regarding status of cases, drug orders and status of alternative funding. -
4. Provide coordination of order for product, shipment of product, and therapy initiation with pharmacy and patient.-15 %
5. Participate in Call Center Activities, triage and respond to incoming calls from patients, insurance companies, physicians, Sales Reps, pharmacies and homecare agencies. May serve as single point of contact for an assigned group of prescribers.-10 %
6. Identify and report events as required by the REMS requirements for specified medication. Recognize adverse event, product quality complaint and potential risk events and forward information to the appropriate team member for reporting to the manufacturer.-5 %
7. Educate patients, prescribers, and others regarding program requirements, and facilitate referrals. Maintain good housekeeping techniques, adhering to quality and production standards and comply with all applicable company, state, and federal safety and environmental programs and procedures. - 5 %
Apex is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178