Reimbursement Specialist
Pride Health is hiring a Home Health – Reimbursement Specialist for one of its healthcare clients in Sarasota FL.
This is a 11-week contract with the possibility of expansion with competitive pay and benefits.
Location: Sarasota FL ,34238.
Length of assignment: 11 weeks (Possibility of an extension)
Pay range: $23 – $25 per hour
Shift / Schedule: Onsite; Monday to Friday – 40.00 Hours Per Week
Job Summary
The Home Health Reimbursement Specialist is responsible for monitoring claim status, researching claim rejections and denials, documenting account activity, and ensuring timely collections from insurance providers. The role requires strong experience in medical billing, claims follow-up, collections, accounts receivable, and reimbursement processes within a fast-paced healthcare environment.
Key Responsibilities
• Monitor and follow up on insurance claims to ensure timely reimbursement.
• Research and resolve denied, rejected, and unpaid claims.
• Perform collections follow-up with Medicaid, Managed Care, Commercial Insurance, and Private Payers.
• Accurately document account activity, claim status updates, and collection efforts.
• Review claims billing information and identify discrepancies or billing errors.
• Work accounts receivable balances and ensure proper resolution of outstanding claims.
• Utilize medical billing systems and database applications to manage claims activity.
• Interpret CPT codes and medical terminology during claim review and reimbursement processes.
• Collaborate with internal departments and insurance carriers to resolve payment issues.
• Maintain productivity and accuracy while working in a high-volume environment.
• Perform mathematical computations and audit billing data to identify errors.
• Support additional reimbursement and billing functions as assigned.
Requirements
• High School Diploma or GED required.
• Minimum one (1) year of current medical billing and collections experience required.
• Strong knowledge of claims billing, insurance follow-up, and accounts receivable.
• Experience working with CPT codes, denials, rejections, and appeals processes.
• Knowledge of medical terminology required.
• Proficiency with Microsoft Office Suite, database applications, and medical billing software.
• Strong communication, interpersonal, and customer service skills.
• Ability to multitask and work independently within a team environment.
• Keyboarding speed of at least 30 WPM required.
• Previous home health billing experience preferred.
• Experience with Medicaid, Managed Care/Insurance, and Private Payers preferred.
Pride-Health offers eligible employee’s comprehensive healthcare coverage (medical, dental, and vision plans), supplemental coverage (accident insurance, critical illness insurance and hospital indemnity), 401(k)-retirement savings, life & disability insurance, an employee assistance program, legal support, auto, home insurance, pet insurance and employee discounts with preferred vendors.
Equal Employment Opportunity
Pride-Health is an equal opportunity employer. We do not discriminate on the basis of the race, religious creed, color, national origin, ancestry, physical disability, mental disability, reproductive health decision making, medical condition, genetic information, marital status, sex, gender, gender identity, gender expression, age, sexual orientation, veteran or military status, or any other characteristic protected by applicable federal, state, or local law.
Fair Chance Employment
Pride-Health is a Fair Chance employer. We consider all qualified applicants, including those with criminal histories, in a manner consistent with applicable state and local Fair Chance laws and ordinances, including, the California Fair Chance Act and all applicable local Fair Chance ordinances.
Accommodations
We are committed to providing reasonable accommodations to applicants and employees with disabilities. If you require reasonable accommodation to participate in the application or interview process, or to perform the essential functions of this role, please contact us.
Only applicable for San Francisco Candidates: Under the San Francisco Lactation in the Workplace Ordinance, we will provide written notice of lactation accommodation rights, and this notice will automatically be given upon hiring, any inquiry of parental leave or lactation accommodation.