Reimbursement Associate

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Reimbursement Associate

@ Tides Medical

Purpose of Position:

• The Reimbursement Associate is responsible for all aspects of the insurance verification and prior authorization process for applicable Tides Medical products.
• This is a front-line position in a fast paced, results driven environment.
• The Reimbursement Associate responds to all provider and internal requests in a timely fashion and is responsible for providing patient specific coding, coverage, and reimbursement information to the company’s customers.

Essential Functions of the Areas of Responsibility:

• Perform the following in accordance with AATB, FDA, and Tides Medical stated policies and procedures while upholding Tides Medical’s mission and corporate values.
• Initiate and coordinate the insurance verification and prior authorization processes for physician office customers
• Perform a detailed insurance verification for product/procedure
• Answer technical reimbursement questions for providers, billing and coding staff, and sales representatives 
• Accurately record all reimbursement correspondence and research in the database per the assigned fields and required metrics
• Analyzes data and draws valid and logical conclusions based on information provided by insurers and documented medical policies
• Communicate insurance verification and prior authorization results to customers and answers all related questions 
• Research customer questions as necessary and communicate with appropriate members of the team to ensure customers receive the highest level of customer service 
• Prioritize duties and tasks as necessary to ensure assignments are completed in a timely fashion 
• Ensure continuous quality improvement and customer service by proactively identifying areas of improvement and communicating those ideas to the management team 
• Coordinate responses and resolutions to issues with appropriate internal and external parties 
• Maintain and promote positive and professional working relationships with associates and management 
• Performs related duties as assigned 

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Qualifications:

Requirements:

Key Qualifications, Requirements, and Attributes:

• Effective communication skills both verbally and in writing
• Strong team player with a demonstrated history of collaboration in a team environment
• Either a 2 or 4-year college degree or 2-5 years or relevant experience in Medical Reimbursement
• Prior experience in a reimbursement-based call center environment, including knowledge of Medicare, Medicaid, and private payer reimbursement methodologies.
• Familiarity with the benefits investigation process (deductible, out of pocket, benefits exclusions, etc.)
• Coding certification and/or training with experience in coding and billing in various settings such as offices, hospitals or ASCs
• Proficiency in handling the prior authorization process for products or services
• Adept at handling sensitive and confidential situations
• Thorough understand and adherence to HIPAA Privacy Rule
• Ability to represent a positive and professional image
• Strong computer skills, including proficiency in Microsoft Word, Excel, PowerPoint, and Outlook, as well as experience with EMR or CRM systems and online resources.

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How to Apply:

Apply at https://www.tidesmedical.com/careers/. 

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