Reimbursement Specialist - Healthcare jobs in Daly City, CA

Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

S
Virtual Field Reimbursement Specialist
  • Syneos Health Commercial Solutions
  • San Francisco, CA FULL_TIME
  • Description

    You are an expert facilitator: you open doors, foster communication, and bridge the gap.

    The Virtual Field Reimbursement Specialist (VFRS) will be responsible for the management of defined accounts in a specified geographic region across numerous therapeutic areas.

    The VFRS will execute the collaborative territory strategic plan through partnership with internal and external stakeholders, which may include call center services (HUB), sales, market access, and other collaboration partners. Responsibilities include ensuring understanding of reimbursement process, field reimbursement services, and patient support programs. The Reimbursement Specialist will also work on patient-level reimbursement issue resolution.

    In this role, the VFRS will demonstrate unwavering support and a consultative approach to help offices obtain insurance authorization and/or reimbursement of products for appropriate patients. The VFRS will have a direct impact on a patient’s ability to access the therapies they need. Additional responsibilities include:

    • Manage daily activities that support appropriate patient access to our client’s products in the provider offices and work as a liaison to other patient assistance and access support services offered by our clients (i.e. HUB, Call Center, Specialty Pharmacy Services)
    • Act as an extension of the call center and/or HUB and provide live one-on-one coverage support
    • Serve as payer expert for defined geography and able to communicate payer changes to key stakeholders in a timely manner
    • Offer office education during the entire access process which may include formulary coverage/utilization management criteria, insurance forms & procedures, benefits investigation, prior authorization, appeal, and/or claims resolution
    • Educate offices using approved materials provided by the client
    • Review patient-specific information in reimbursement cases where the office has specifically requested assistance in resolving access issue or coverage challenge
    • Educate physician office staff on the use of our client’s patient support services, including web based provider portals

    Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:

    • Bachelor’s Degree
    • Minimum two years of experience in public or private third party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
    • Experience with specialty/biologic or physician administered products
    • Demonstrated ability to educate offices on access processes – including but not limited to:
      • Experience educating HCPs on client specific Patient Service programs (i.e. copay, nurse education, bridge, patient assistance, etc.)
      • Experience delivering educational presentations
      • Advanced knowledge of medical insurance terminology
    • Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B & D
    • Must live within territory or within territory boundaries.

    The annual base salary for this position ranges from $112,000 to $118,000. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate's qualifications, skills, competencies, and proficiency for the role. In addition, some positions may include eligibility to earn commissions/bonus based on company and / or individual performance.

    At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.

    Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients’ lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients' lives around the world.

    Work Here Matters Everywhere | How are you inspired to change lives?

    Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)

    Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.
    At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.

    #LI-West

  • 11 Days Ago

S
Virtual Field Reimbursement Specialist
  • Syneos Health Clinical
  • San Francisco, CA FULL_TIME
  • Description You are an expert facilitator: you open doors, foster communication, and bridge the gap. The Virtual Field Reimbursement Specialist (VFRS) will be responsible for the management of defined...
  • 11 Days Ago

P
Sales Support Healthcare Specialist
  • PrimoMD
  • San Rafael, CA FULL_TIME
  • About Us:At PrimoCare, we are on a mission to revolutionize healthcare delivery by utilizing technology to improve patient outcomes. As a rapidly growing healthcare organization, we are currently seek...
  • 20 Days Ago

P
Sales Support Healthcare Specialist
  • PrimoCare
  • San Rafael, CA FULL_TIME
  • About Us:At PrimoCare, we are on a mission to revolutionize healthcare delivery by utilizing technology to improve patient outcomes. As a rapidly growing healthcare organization, we are currently seek...
  • 21 Days Ago

P
Support Healthcare Specialist
  • PrimoMD
  • San Rafael, CA FULL_TIME
  • Support Healthcare Specialist (NOT REMOTE) Plenty of drivingAbout Us:At PrimoCare, we are on a mission to revolutionize healthcare delivery by utilizing technology to improve patient outcomes. As a ra...
  • 12 Days Ago

M
Certified Enrollment Counselor or Healthcare Insurance Enrollment Specialist
  • Marin Community Clinics
  • San Rafael, CA FULL_TIME
  • Overview Marin Community Clinics, founded in 1972, is today, a multi-clinic network with a wide array of integrated primary care, dental, behavioral, specialty and referral services. As a Federally Qu...
  • 20 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Reimbursement Specialist - Healthcare jobs found in Daly City, CA area

M
Member Support Associate (Work From Home)>
  • Modern Health
  • San Bruno, CA
  • [Customer Service / Remote] - Anywhere in U.S. / Competitive Pay / Medical, Dental, Vision, Disability & Life Insurance ...
  • 3/29/2024 12:00:00 AM

A
Executive Director / Vice President of Health Economics and Outcomes Research (HEOR)
  • Annexon, Inc.
  • Brisbane, CA
  • Executive Director / VP / Senior VP Health Economics and Outcomes Research Work Location Corporate Headquarters (South S...
  • 3/28/2024 12:00:00 AM

V
Clinical Reimbursement Specialist - RN
  • Vi Living
  • Palo Alto, CA
  • Overview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from th...
  • 3/27/2024 12:00:00 AM

U
Intern, Regulatory Project Management
  • Ultragenyx Pharmaceutical
  • Brisbane, CA
  • Why Join Us? Be a hero for our rare disease patients At Ultragenyx, we fundamentally believe that taking real impactful ...
  • 3/27/2024 12:00:00 AM

B
Reimbursement Specialist
  • By The Bay Health
  • Larkspur, CA
  • This position offers competitive pay, generous benefits, and a supportive work environment! We are seeking a full-time R...
  • 3/25/2024 12:00:00 AM

V
Clinical Reimbursement Specialist - LVN
  • Vi Living
  • Palo Alto, CA
  • Overview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from th...
  • 3/19/2024 12:00:00 AM

S
Merchandising Specialist
  • SAS Retail Services
  • South San Francisco, CA
  • Join our dynamic team of Merchandising & Product Demonstration Specialists! In this multifaceted role, you'll excel in m...
  • 3/7/2024 12:00:00 AM

S
Merchandising Specialist
  • SAS Retail Services
  • Daly City, CA
  • Join our dynamic team of Merchandising & Product Demonstration Specialists! In this multifaceted role, you'll excel in m...
  • 3/6/2024 12:00:00 AM

Daly City (/ˈdeɪli/) is the largest city in San Mateo County, California, United States, with an estimated 2014 population of 106,094. Located immediately south of San Francisco, it is named in honor of businessman and landowner John Donald Daly. According to the United States Census Bureau, the city has a total area of 7.7 square miles (20 km2), all land. Daly City is bordered by the cities of San Francisco, Brisbane, Pacifica, South San Francisco, and the town of Colma. The city borders several unincorporated areas of San Mateo County. It surrounds Broadmoor, borders San Bruno Mountain State...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$56,631 to $68,813
Daly City, California area prices
were up 4.5% from a year ago

Reimbursement Specialist - Healthcare in Anchorage, AK
Bureau of Labor Statistics, occupations and industries related to healthcare are projected to add more new jobs to the U.S.
December 07, 2019
Reimbursement Specialist - Healthcare in Brownsville, TX
You will also be notified when something of note is happening around the Coding and Reimbursement Specialist program.
January 26, 2020
Reimbursement Specialist - Healthcare in Charlotte, NC
MedCert’s Reimbursement and EHR Specialist Certification program is well rounded and features 24/7 access to the curriculum with video and course content, program supplements, and all the resources your need for successful independent study.
January 08, 2020