Reimbursement Specialist (ID #512716)

Posted 2 days ago

partners personnelLanghorne (PA)

Claims Adjusters, Examiners, and Investigators Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds

SENIORITY

Senior

SALARY

$20.00 - $22.00 per hour

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About the role

Medicare/Medicaid Claims Specialist 3-5+ years of experience understanding Medicare/Medicaid requirements Pay Range: $20$22/hr Role Responsibilities: Submit CMS-1500 claims for custom orthotics, prosthetics, and durable medical equipment (DME), utilizing specific HCPCS codes/modifiers. Investigate denied claims, analyze denial trends and prepare appeals backed by clinical documentation Ensure compliance with Medicare's Local Coverage Determinations (LCDs), National Coverage Determinations (NCDs), and prior authorization

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