Reimbursement Specialist I

GROW WITH US: Tandem Diabetes Care creates new possibilities for people living with diabetes, their loved ones, and their healthcare providers through a positively different experience. We’d love for you to team up with us to “innovate every day,” put “people first,” and take the “no-shortcuts” approach that has propelled us to become a leader in the diabetes technology industry. STAY AWESOME: Tandem Diabetes Care is proud to manufacture and sell the Tandem Mobi system and t:slim X2 insulin pump with Control-IQ+ technology — an advanced predictive algorithm that automates insulin delivery. But we’re so much more than that. Our company’s human-centered approach to design, development, and support delivers innovative products and services for people who use insulin. Because many of our own team members live with diabetes, or have a loved one impacted by diabetes, the work is personal, and we are committed to the cause. Learn more at tandemdiabetes.com A DAY IN THE LIFE: The primary responsibility of this position is to assure all insurance claims are processed timely, accurately, and efficiently. The Reimbursement Specialist is responsible to secure payments from both contracted and non-contracted insurance entities as well as customers. This position will work closely with our Customer Sales Support to assure data accuracy as well as communicating requirements from health insurance plans. ** Please note; The shift for this role is; Mon - Friday, 630am - 3pm pst. ** Reimbursement Specialists at Tandem are also responsible for: Reviews medical criteria to assure patient documentation meets standards. Carefully reviews all patient related data and documentation for accuracy prior to claim submission. Creates and submits healthcare claims to insurance companies. Communicates with patients to advise on status of insurance claims, as necessary. Contacts patients regarding collection of outstanding invoices. Fields inbound calls from patients regarding inquiries related to insurance claims. Makes outbound investigational calls to insurance providers to determine status of outstanding claims. Negotiates structured payment plans. Accesses CRM to receive and provide up to date patient claim information. Keeps up to date with specifications on all Tandem products and services. Confirms completion of required training plan before assuming job responsibilities. Ensures work is performed in compliance with company policies including Privacy/HIPAA and other regulatory, legal, and safety requirements. WHAT YOU’LL NEED: BA/BS or equivalent combination of education and applicable job experience. 2+ years of experience in medical billing or equivalent experience. Experience in a HIPAA controlled environment is required. Experience billing durable medical equipment is preferred. Experience in diabetes or other disease management device/diagnostics is preferred. Understanding of medical billing, insurance claim processing, and follow up procedures. Understanding of all data required on a Health Care Financing Administration (HCFA) 1500 billing form. Knowledge of billing codes and modifiers assigned by the Centers for Medicare and Medicaid Services (CMS). Ability to understand Explanation of Benefits provided by heath care providers. Knowledge of claims clearing houses and the basic functionality of these services. Demonstrated ability to effectively communicate over the phone with customers and insurance companies to resolve clear-cut issues and answer questions according to department protocols and requirements. Able to effectively share information related to work product in verbal and written form. Able to contribute to the team by supporting the acceptance of new team members. Demonstrated ability to work accurately, to follow instructions and schedules, and handle multiple priorities. Experience with MS Office suite (Word, Excel, and Outlook), Internet, & customer relationship management systems (CRM). WHEN & WHERE YOU’LL WORK: Remote; Shift; Mon - Fri, 630am - 3pm pst. This position is fully remote and open to candidates within the United States.  Equipment for the role will be provided and training will occur virtually.  COMPENSATION & BENEFITS: The starting base pay range for this position is $23.00 - $25.00 per hour. Base pay will vary based on job-related knowledge, skills, experience and may also fluctuate depending on candidate’s location and the overall job market. In addition to base pay, Tandem offers a competitive compensation package that includes bonus and a robust benefits package. Tandem offers health care benefits such as medical, dental, vision available your first day, as well as health savings accounts and flexible saving accounts.  You’ll also receive 11 paid holidays per year, a minimum of 20 days of paid time off (with accrual starting on day 1) and you will have access to a 401k plan with company match as well as an Employee Stock Purchase plan.  Learn more about Tandem’s benefits here ! YOU SHOULD KNOW:  Qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable state and local Fair Chance laws and regulations. A conditional offer of employment from Tandem is contingent upon successful completion of a pre-employment screening process comprised of a drug test (excluding marijuana) and background check, which includes a review of criminal history information. Tandem has good cause to conduct a review of criminal history information of candidates for this position, as this role may involve access to proprietary, sensitive and/or confidential information, including customer protected health information. This review is required to ensure that individuals in such roles uphold high standards of trust and integrity so as to protect the interests of our customers, employees, and stakeholders. SPONSORSHIP:   Applicants must be authorized to work for any employer in