You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.
Job Summary
The Reimbursement Specialist is a vital member of our client's RxB Reimbursement team, responsible for managing a comprehensive range of patient financial support services and executing various wraparound tasks. This role involves cross-training within the Out-of-Pocket (OOP) department and the RxB Reimbursement AR Collector.
Responsibilities / Job Duties
- Monitor and manage alerts and notes related to OOP.
- Ensure timely and accurate task execution.
- Enforce and adhere to all Policies and Procedures.
- Maintain accurate documentation of all interactions and actions.
- Collaborate with internal teams to resolve issues quickly and efficiently.
- Bill OOP to Medi-Cal.
- Create and update patient accounts.
- Educate patients on online payment methods and collect credit card payments over the phone.
- Manage AIC iPad tools for payment collection.
- Demonstrate expert understanding of patient invoices, including deductibles, coinsurance, copayments, coverage gaps, and cash pay options.
- Initiate and manage cases under hardship and free drug programs, LIS, MPP/M3P, patient and pharmaceutical assistance programs, and PBM Tier Exception requests.
- Assess patient eligibility for payment plans, initiate and manage cases, and terminate ineligible cases.
- Maintain and manage the COD Report and lead the COD Chat process.
Qualifications
- Proficiency in understanding insurance out-of-pocket expenses and their implications.
- Experience with billing out-of-pocket expenses to secondary payors.
- Strong understanding of coordination of benefits.
- Familiarity with Copay and/or Pharmaceutical Assistance Programs.
Benefits
- Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
- Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
- 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
- Short Term Disability Insurance.
- Term Life Insurance Plan.
*We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).
This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.
Medix Overview:
With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we’re dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.
