Job Description

On behalf of Ajinomoto Cambrooke , we are searching for their next Reimbursement Authorization Specialist .

Job Summary

Are you looking for a new professional challenge? ✨ Then keep on reading!

As a recruiting partner of Ajinomoto Cambrooke we are looking for you as Reimbursement Authorization Specialist (a) at the location in Ayer, MA . In your position, you'll manage and ensure the accuracy of all necessary documentation and coordination with healthcare professionals, agencies, and payers to facilitate patient access to products while maintaining compliance and providing top-notch customer service.

As an employee you will be part of a diverse, innovative, and collaborative community dedicated to improving lives through nutrition and health.

Enjoy benefits such as life insurance, discounts on selected external services, and expense reimbursement!

We have sparked your interest? Then arrange an initial interview with us now!

Experience a salary range of $22.70 - $30.00 hourly.

#Reimbursement #Authorization #Specialist #JobOpportunity #AjinomotoJobs

• Ensure Ajinomoto Cambrooke, Inc. (ACI) has the necessary documentation to start the referral process.
• Contact healthcare professionals, state agencies, and payers (insurance companies) for clinical documents, eligibility, benefits, prior authorization, single case agreements, letter of agreements and any other items to ensure payment on an as needed basis (e.g., when authorization expires).
• Assists in uploading current documents and populating required fields in Sales Force.
• Continue to work and maintain such documents so effective dates are always current.
• Ensures all incoming requests are worked and responded to timely, following the guidelines set forth within Revenue Cycle Department.
• Coordinate with other contracted Durable Medical Equipment companies and/or Pharmacies to ensure that patient(s) and their families can obtain the formula and medical foods they require.
• Provides assistance and guidance for patient(s) and their families working through eligibility, benefit verification and prior authorization process with payers.
• Provides excellent customer service resolving inquiries & issues in a timely, professional, and caring manner with compassion and drive to ensure patient(s) and their families receive optimal coverage so they can receive Cambrooke products with the least financial impact on them.
• Prioritizes Pre-Order Tracker and Cases that are “In process” beyond 30 days.
• Maintain medical records in compliance with HIPAA rules and regulations.
• Adhering to all company SOPs with regards quality and safety.

• Minimum High School Diploma or equivalent.
• Multiple years work experience in medical billing, eligibility, authorization, and interaction with payers.
• Understanding of HCPCs and ICD10 coding.
• Knowledge of third-party rules and regulations to include contracts and agreements.
• Proficiency in Microsoft Office; Excel, Word, Teams, etc.
• Ability to multi-task, with attention to detail to ensure accuracy.
• Able to prioritize work, anticipate department needs, plan accordingly and able to handle the many interruptions with ease.
• Strong written and oral communications skills required to provide excellent customer service and/or Revenue Cycle updates.
• Demonstrated sense of compassion and drive to ensure patient(s) and their families receive optimal coverage so they can receive Cambrooke products.
• Ability to work independently with minimal direction, take initiative within scope of work responsibilities
• Must be a strong team player working with the various Revenue Cycle Teams and be able to initiate activity and/or promptly communicate & mentor others.
• Must have great listening skills to work with team members, other colleagues, and outside customers & clinics, to identify and initiate suggestions, guidance and/or resolution.
• Must be results and people-orientated having the ability to balance business and relationship considerations.
• Knowledge of HIPAA and the ability to maintain confidential information security relative to all company’s proprietary information.
• Must maintain information security with regard to all company’s proprietary information.

• English: C1 – Advanced

• College degree.
• Previous experience with SalesForce or Nexternal preferred.

• Reports to: Director of Revenue Cycle

• Contribution to health insurance
• Wellness and mental health benefits
• Employee life insurance
• Discounts to selected external services (dry cleaning, technology, etc.)
• Expense reimbursement (milage, rentals, etc.)
• Laptop, Tablet, Company Cell Phone
• 3 Weeks Paid Time Off
• Short and Long Term Disability coverage
• Fitness reimbursement

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