Reimbursement Specialist

About the role: The Reimbursement Specialist is responsible for managing the full reimbursement lifecycle including claim preparation submission and account follow-up to ensure accurate and timely reimbursement. This role serves as the primary owner of assigned accounts receivable activities and collaborates with internal teams to resolve billing issues reduce outstanding balances and maximize revenue collection. 

Responsibilities: 

• Review claims and billing documentation for accuracy and completeness prior to submission to ensure compliance with payer requirements and reimbursement guidelines  

• Submit claims through TrueSight payer portals and invoicing processes for insurance reseller alternate funding and other non-traditional reimbursement channels  

• Monitor submitted claims and invoices to ensure timely processing payment and resolution of outstanding balances  

• Perform timely follow-up with insurance companies patients caregivers resellers and other external partners to resolve payment issues and facilitate reimbursement  

• Review identify and correct claim rejections billing errors and submission issues to support timely resubmission and payment  

• Investigate claim denials underpayments and outstanding balances to determine root causes and implement appropriate resolution strategies  

• Submit appeals and supporting documentation for denied or underpaid claims to maximize reimbursement  

• Manage patient financial responsibilities including establishing payment plans sending payment links and coordinating payment resolution prior to shipment and case completion  

• Monitor and manage assigned Accounts Receivable to reduce aging balances and support departmental collection goals  

• Maintain accurate and timely documentation of all billing collection and account activity within applicable systems  

• Collaborate with internal teams to identify trends resolve reimbursement barriers and improve billing and collection processes  

• Maintain compliance with payer requirements reimbursement regulations and company policies  

• Maintain confidentiality and adhere to HIPAA standards when handling Protected Health Information (PHI)  

• Maintain current knowledge of payer requirements billing processes reimbursement guidelines and industry regulations 

• May berequiredto perform other duties as assigned  

Qualifications :

Minimum Qualifications: 

• High School Diploma or equivalent 

• 13 years of experience in medical reimbursement DME medical billing or healthcare revenue cycle management 

• 1-3 years of experience using medical billing or claims management software such as TrueSight 

• 1-3 years of experience using payer and/or clearinghouse portals such as MyCGS or Inovalon 

• Strong attention to detail organization problem-solving and follow-up skills 

• Strong written and verbal communication skills 

• Ability to effectively manage multiple and shifting priorities in a fast-paced environment 

• Ability and willingness to travel within the U.S. (including airline travel) up to 2 times per year for in-person team and all-company meetings with possible additional travel (approximately 2 times annually) for conferences and events as needed 

Preferred Qualifications: 

• Experience managing both billing and collections activities within the reimbursement lifecycle 

• Experience working with patient balances payment plans and electronic payment solutions 

• Proficiency with Microsoft Office applications particularly Excel and Outlook 

• Familiarity with TrueSight and/or Inovalon 

• Experience working with confidential or protected health information in a healthcare environment  

• Knowledge of HIPAA and healthcare privacy requirements  

• Experience with DMEPOS reimbursement particularly Medicare DMEPOS 

Additional Information :

Work Environment & Physical Demands 
Work is performed remotely from a home office. The individual is expected to maintain a safe productive workspace with reliable and secure internet access.  

Travel 

Ability and willingness to travel within the U.S. (including airline travel) up to 2 times per year for in-person team and all-company meetings with possible additional travel (approximately 2 times annually) for conferences and events as needed 

Accommodations  
To perform this job successfully an individual must be able to perform each essential duty and physical demand satisfactorily. The requirements listed above are representative of the knowledge skills and/orabilitiesand physical demands required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 

If you require an accommodation please reach out to Human Resources at  for assistance. We are here to help! 

Lingraphica and Pay Transparency  

At Lingraphica we are committed to fair and equitable compensation practices. The starting salary range for this position is $50000 to $55000 per year. Placement in the starting pay is based on factors such as experience skills education and internal equity. We regularly review our compensation structures to ensure they align with industry standards promote fairness and support career addition to competitive base pay we offer a comprehensive benefits package and a commitment to fostering an inclusive and supportive workplace. We encourage open conversations about compensation and are dedicated to maintaining transparency throughout the hiring process. 

To learn more about Lingraphica visit: ! To learn more about our benefits offerings click here!

This Organization Participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in the U.S. 

Este empleador participa en E-Verify y proporcionará al gobierno federal la información de su Formulario I-9 para confirmar que usted está autorizado para trabajar en los EE. UU.

Remote Work :

Yes

Employment Type :

Full-time