Reimbursement Specialist - Healthcare jobs in Livonia, MI

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)

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Field Reimbursement Specialist
  • Syneos Health Clinical
  • Detroit, MI FULL_TIME
  • Description

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

    In this role, you will be responsible for the management of defined accounts in a specified geographic region in the respiratory therapeutic area, specifically supporting our client’s products. The Field Reimbursement Specialist (FRS) 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. The FRS will have a direct impact on a patient’s ability to access the therapies they need. You will:

    • 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)
    • 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 physician office staff on the use of our client’s patient support services, including web based provider portals

    Essential Requirements:

    • Bachelor’s degree
    • 2 years’ experience in public or private third party access arena or pharmaceutical industry in managed care, clinical support, and/or sales
    • Experience with specialty/biologic self-injectable (pharmacy benefit) or physician administered (buy and bill/medical benefit) products
    • Demonstrated ability to educate offices on access processes

    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.

  • 16 Days Ago

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Credentialing Specialist - Healthcare (Remote)
  • Morgan Stephens
  • Detroit, MI FULL_TIME
  • Job Title: Provider Credentialing Specialist (Temporary to Perm) Healthcare Experience REQUIRED Fully Remote - Candidate must live in Michigan Location: Remote (8AM-5PM EST) Experience Required: 1 Yea...
  • 7 Days Ago

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Healthcare Sales Specialist
  • CorsoCare
  • Troy, MI FULL_TIME
  • Healthcare Sales Specialist CorsoCare Home Health & Hospice Oakland and Macomb County area Competitive wages and Incentive Compensation plan Comprehensive benefits Generous PTO/Holiday (23 days first ...
  • 29 Days Ago

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Credentialing Specialist
  • Centria Healthcare
  • Farmington, MI FULL_TIME
  • Every child deserves the brightest future and Centria Autism Services is on a mission to help children with Autism Spectrum Disorder (ASD) have the best developmental experience possible while acquiri...
  • 10 Days Ago

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General Laborer
  • Roberts & Son Black Oxide Specialist
  • Roseville, MI FULL_TIME
  • Roberts & Son Black Oxide Specialist Inc is currently looking for a General Laborer to join our company.Responsibilities:Racking and unracking steel parts.Handling responsibility in shipping and recei...
  • 22 Days Ago

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Field Reimbursement Manager
  • Syneos Health Commercial Solutions
  • Detroit, MI FULL_TIME
  • Description You are an expert facilitator: you open doors, foster communication, and bridge the gap. The Field Reimbursement Manager will be responsible for the management of defined accounts in Urolo...
  • 22 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Livonia, MI area

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Farmington, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Plymouth, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Inkster, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Oak Park, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Romulus, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Highland Park, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Garden City, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Southgate, MI
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

Livonia is a city in the northwest part of Wayne County in the U.S. state of Michigan. It is a large suburb with an array of traditional neighborhoods (most of which were built in the 1950s and 1960s) connected to the metropolitan area by freeways. The population was 96,942 at the 2010 census, making it Michigan's ninth largest municipality. The municipality is a part of Metro Detroit, and is located approximately 15 miles (24 km) northwest of downtown Detroit, and less than two miles (3 km) from the western city limits of Detroit (Redford Township lies between the two). According to the Unite...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$45,273 to $55,012
Livonia, Michigan area prices
were up 1.2% from a year ago

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