Reimbursement Specialist

Summary

Lingraphica is a mission-driven organization that provides speech-generating devices and augmentative and alternative communication technology for people with communication impairments. The Reimbursement Specialist manages the full reimbursement lifecycle, including claim preparation, submission, follow-up, appeals, patient financial responsibilities, and accounts receivable activities to support timely payment and maximize revenue collection.

Responsibilities

• Review claims and billing documentation for accuracy and completeness prior to submission to ensure compliance with payer requirements and reimbursement guidelines
• Submit claims through TrueSight, payer portals, and invoicing processes for insurance, reseller, alternate funding, and other non-traditional reimbursement channels
• Monitor submitted claims and invoices to ensure timely processing, payment, and resolution of outstanding balances
• Perform timely follow-up with insurance companies, patients, caregivers, resellers, and other external partners to resolve payment issues and facilitate reimbursement
• Review, identify, and correct claim rejections, billing errors, and submission issues to support timely resubmission and payment
• Investigate claim denials, underpayments, and outstanding balances to determine root causes and implement appropriate resolution strategies
• Submit appeals and supporting documentation for denied or underpaid claims to maximize reimbursement
• Manage patient financial responsibilities, including establishing payment plans, sending payment links, and coordinating payment resolution prior to shipment and case completion
• Monitor and manage assigned Accounts Receivable to reduce aging balances and support departmental collection goals
• Maintain accurate and timely documentation of all billing, collection, and account activity within applicable systems
• Collaborate with internal teams to identify trends, resolve reimbursement barriers, and improve billing and collection processes
• Maintain compliance with payer requirements, reimbursement regulations, and company policies
• Maintain confidentiality and adhere to HIPAA standards when handling Protected Health Information (PHI)
• Maintain current knowledge of payer requirements, billing processes, reimbursement guidelines, and industry regulations
• May be required to perform other duties as assigned

Skills

• High School Diploma or equivalent
• 1–3 years of experience in medical reimbursement, DME, medical billing, or healthcare revenue cycle management
• 1-3 years of experience using medical billing or claims management software, such as TrueSight
• 1-3 years of experience using payer and/or clearinghouse portals, such as MyCGS or Inovalon
• Strong attention to detail, organization, problem-solving, and follow-up skills
• Strong written and verbal communication skills
• Ability to effectively manage multiple and shifting priorities in a fast-paced environment
• Ability and willingness to travel within the U.S. (including airline travel) up to 2 times per year for in-person team and all-company meetings with possible additional travel (approximately 2 times annually) for conferences and events as needed
• Experience managing both billing and collections activities within the reimbursement lifecycle
• Experience working with patient balances, payment plans, and electronic payment solutions
• Proficiency with Microsoft Office applications, particularly Excel and Outlook
• Familiarity with TrueSight and/or Inovalon
• Experience working with confidential or protected health information in a healthcare environment
• Knowledge of HIPAA and healthcare privacy requirements
• Experience with DMEPOS reimbursement, particularly Medicare DMEPOS

Qualifications

Must Haves

• High School Diploma or equivalent
• 1–3 years of experience in medical reimbursement, DME, medical billing, or healthcare revenue cycle management
• 1-3 years of experience using medical billing or claims management software, such as TrueSight
• 1-3 years of experience using payer and/or clearinghouse portals, such as MyCGS or Inovalon
• Strong attention to detail, organization, problem-solving, and follow-up skills
• Strong written and verbal communication skills
• Ability to effectively manage multiple and shifting priorities in a fast-paced environment
• Ability and willingness to travel within the U.S. (including airline travel) up to 2 times per year for in-person team and all-company meetings with possible additional travel (approximately 2 times annually) for conferences and events as needed

Nice to Haves

• Experience managing both billing and collections activities within the reimbursement lifecycle
• Experience working with patient balances, payment plans, and electronic payment solutions
• Proficiency with Microsoft Office applications, particularly Excel and Outlook
• Familiarity with TrueSight and/or Inovalon
• Experience working with confidential or protected health information in a healthcare environment
• Knowledge of HIPAA and healthcare privacy requirements
• Experience with DMEPOS reimbursement, particularly Medicare DMEPOS

Benefits

• Work is performed remotely from a home office.