Experienced Reimbursement Specialist – Healthcare Benefits Verification

Job Summary:

Join arenaflex as a skilled Reimbursement Specialist, where you will play a vital role in ensuring seamless healthcare services for patients and providers. As a key member of our team, you will be responsible for verifying patient insurance benefits, confirming coverage, and facilitating reimbursement for healthcare services. With a strong focus on customer service, communication, and problem-solving, you will work closely with insurance providers, healthcare professionals, and patients to resolve issues and ensure timely reimbursement.

Job Description:

About arenaflex:

arenaflex is a leading provider of innovative solutions in the healthcare industry. Our mission is to empower healthcare providers with the tools and expertise they need to deliver exceptional patient care. We are committed to fostering a culture of excellence, collaboration, and continuous learning. As a Reimbursement Specialist at arenaflex, you will be part of a dynamic team that is dedicated to making a positive impact in the lives of patients and healthcare professionals.

Key Responsibilities:

* Place outbound calls to verify patient insurance benefits and confirm coverage changes

• Contact insurance providers to collect and review patient insurance benefit information
• Manage insurance benefit management, including collecting and reviewing patient insurance benefit information, completing and submitting insurance forms and prior authorizations in a timely manner
• Provide exceptional customer service to internal and external customers, resolving requests promptly and escalating complaints as needed
• Maintain regular phone contact with provider representatives, third-party customer service reps, and pharmacy staff
• Effectively communicate with payors for benefit investigations and coordinate with inter-departmental associates as necessary
• Process insurance and patient correspondence, report reimbursement trends or delays to the supervisor, and provide all necessary documentation for prior authorizations
• Analyze moderate scope problems within defined SOPs, exercising judgment to determine appropriate actions, and report all adverse events in line with training and SOP

Requirements:

* 1 year of experience in specialty pharmacy, medical insurance, healthcare setting, and/or related experience

• Must be patient: Hold times may be up to 90 minutes by client requirements
• Must have a private, designated workspace
• Must be MS Office proficient: Excel, Outlook, Word
• Must be flexible on schedule and hours
• Employment verification required: Last 3 employers
• High school diploma or equivalent
• Background check required

Preferred Qualifications:

* 2+ years of experience in healthcare benefits verification

• Experience with CRM systems and prior authorization processes
• Strong communication and problem-solving skills
• Ability to work in a fast-paced environment with multiple priorities
• Experience working with electronic health records (EHRs) and practice management systems (PMS)

Training and Development:

* Approximately 3 weeks of training, consisting of practice and mock calls

• Various assessments during training, candidates must meet the program score requirements by Dec 31
• Hands-on learning of CRM, specific client program protocol requirements, and navigation of the system

Work Environment and Culture:

* Fully remote work arrangement with occasional on-site meetings in Lake Mary, FL

• Collaborative and dynamic team environment
• Opportunities for professional growth and development
• Recognition and rewards for outstanding performance

Compensation and Benefits:

* $18.00 per hour (base rate)

• $19.00 per hour for 2+ years of experience specific to healthcare benefits verification
• Paid training and development opportunities
• Flexible scheduling and work-life balance
• Comprehensive benefits package, including health, dental, and vision insurance, 401(k) matching, and paid time off

How to Apply:

If you are a motivated and detail-oriented individual with a passion for healthcare and customer service, we encourage you to apply for this exciting opportunity. Please submit your application, including your resume and a cover letter, through our online portal. We look forward to reviewing your application and discussing this opportunity further.

Note:

* Position information session with Team Hiregy (face-to-face meeting)

• Candidate sign "Right to Represent" to work with Hiregy on the project
• Position requirements checklist and action items issued to candidate
• Candidate to complete Spark Hire one-way video interview
• Hiring decision will be made off Spark Hire interview
• If selected, successfully participate in, and complete all new hire requirements
• If selected, pick up equipment in Lake Mary, FL
• If selected, complete mandatory online pre-assignment links (HIPAA, etc.)
• If selected, must successfully complete training (training is paid) by Dec 31
• If selected, must return equipment in Lake Mary, FL

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