Reimbursement Payer Analyst - Option Care Health
Springfield, IL
About the Job
Extraordinary Careers. Endless Possibilities.
With the nation’s largest home infusion provider, there is no limit to the growth of your career.
Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 6,000 team members including 2,900 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees.
As a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a thriving workforce that is as diverse as the patients and communities we serve.
Join a company that is taking action to develop a culture that is more inclusive, respectful, engaging and rewarding for all team members. We are committed to hiring, developing, and retaining a diverse workforce.
Job Description Summary:
Responsible overall support of payers to include training, audit, system & software needs. Represent the division in payer reimbursement issues to internal and external customers.
Job Description:
Job Responsibilities:
+ Responsible for creating and conducting payer training for the field and the corporate employees.
+ Creates and conducts audit programs for field and corporate staff and serves as company contact for Payer audits and issues.
+ Responsible for facilitating payer billing software / hardware program implementation and training for field and corporate staff.
+ Reviews payer referrals per established approval processes.
+ Assists with the enrollment of offices into the various payer plans.
+ Assists individual branch locations with determining payer qualification.
+ Responsible for maintaining database to quantify and trend payer related referral, audit, denial and payment data; develops and maintain required database as directed by the Reimbursement Manager.
Supervisory Responsibilities: i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.
No
Basic Education and/or Experience Requirements:
High School Diploma and at least 2 year of healthcare intake/admissions and/or reimbursement experience.
Basic Qualifications & Interests:
+ Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).
+ Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns).
+ Basic skill level in Microsoft PowerPoint (for example: inserting, rearranging, hiding and deleting slides, navigating between slides, increasing list level, adding, centering and editing text, changing views, inserting a table or a note, moving objects, printing outline view and/or running a slide show).
Preferred Qualifications & Interests:
Previous Infusion Reimbursement experience.
At least 1 year of experience applying knowledge of payer reimbursement guidelines.
This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties.
Due to state pay transparency laws, the full range for the position is below:
Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.
Pay Range is $52,293.20-$87,155.33
Benefits:
-401k
-Dental Insurance
-Disability Insurance
-Health Insurance
-Life Insurance
-Paid Time off
-Vision Insurance
_Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information._
For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.
With the nation’s largest home infusion provider, there is no limit to the growth of your career.
Option Care Health, Inc. is the largest independent home and alternate site infusion services provider in the United States. With over 6,000 team members including 2,900 clinicians, we work compassionately to elevate standards of care for patients with acute and chronic conditions in all 50 states. Through our clinical leadership, expertise and national scale, Option Care Health is re-imagining the infusion care experience for patients, customers and employees.
As a two-year recipient of the Gallup Exceptional Workplace Award, we recognize that part of being extraordinary is building a thriving workforce that is as diverse as the patients and communities we serve.
Join a company that is taking action to develop a culture that is more inclusive, respectful, engaging and rewarding for all team members. We are committed to hiring, developing, and retaining a diverse workforce.
Job Description Summary:
Responsible overall support of payers to include training, audit, system & software needs. Represent the division in payer reimbursement issues to internal and external customers.
Job Description:
Job Responsibilities:
+ Responsible for creating and conducting payer training for the field and the corporate employees.
+ Creates and conducts audit programs for field and corporate staff and serves as company contact for Payer audits and issues.
+ Responsible for facilitating payer billing software / hardware program implementation and training for field and corporate staff.
+ Reviews payer referrals per established approval processes.
+ Assists with the enrollment of offices into the various payer plans.
+ Assists individual branch locations with determining payer qualification.
+ Responsible for maintaining database to quantify and trend payer related referral, audit, denial and payment data; develops and maintain required database as directed by the Reimbursement Manager.
Supervisory Responsibilities: i.e. hiring, recommending/approving promotions and pay increases, scheduling, performance reviews, discipline, etc.
No
Basic Education and/or Experience Requirements:
High School Diploma and at least 2 year of healthcare intake/admissions and/or reimbursement experience.
Basic Qualifications & Interests:
+ Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).
+ Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns).
+ Basic skill level in Microsoft PowerPoint (for example: inserting, rearranging, hiding and deleting slides, navigating between slides, increasing list level, adding, centering and editing text, changing views, inserting a table or a note, moving objects, printing outline view and/or running a slide show).
Preferred Qualifications & Interests:
Previous Infusion Reimbursement experience.
At least 1 year of experience applying knowledge of payer reimbursement guidelines.
This job description is to be used as a guide for accomplishing Company and department objectives, and only covers the primary functions and responsibilities of the position. It is in no way to be construed as an all-encompassing list of duties.
Due to state pay transparency laws, the full range for the position is below:
Salary to be determined by the applicant's education, experience, knowledge, skills, and abilities, as well as internal equity and alignment with market data.
Pay Range is $52,293.20-$87,155.33
Benefits:
-401k
-Dental Insurance
-Disability Insurance
-Health Insurance
-Life Insurance
-Paid Time off
-Vision Insurance
_Option Care Health subscribes to a policy of equal employment opportunity, making employment available without regard to race, color, religion, national origin, citizenship status according to the Immigration Reform and Control Act of 1986, sex, sexual orientation, gender identity, age, disability, veteran status, or genetic information._
For over 40 years, Option Care Health has provided adult and pediatric patients with an alternative to hospital infusion therapy. With more than 2,900 clinical experts, Option Care Health is able to provide high-quality infusion services for nearly all patients with acute and chronic conditions across the United States, resulting in high quality outcomes at a significantly reduced cost. Option Care Health has more than 70 infusion pharmacies and 100 alternate treatment sites. We are guided by our purpose to provide extraordinary care that changes lives through a comprehensive approach to care along every step of the infusion therapy process including: intake coordination, insurance authorization, resources for financial assistance, education and customized treatments.
Source : Option Care Health
