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 $25.75 - $30.00 hourly + bonus + benefits (e.g. tuition reimbursement).

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What You Will Be Doing

• 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.

What You Bring To The Job

• Minimum High School Diploma or equivalent.
• At least 2+ years work experience in patient intake, eligibility and benefits, prior authorizations and interaction with payers, clinicians.
• Understanding of CPT/HCPCs and ICD10 coding.
• Knowledge of third-party rules and regulations to include contracts and agreements.  
• 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 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.
• Proficiency in Microsoft Office; Excel, Word, Teams, etc.

Nice-to-Haves

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

Team

You can expect a friendly team that always supports each other and maintains a very open and collegial atmosphere. The corporate culture is characterized by flat hierarchies, direct communication, and transparency at all levels. You will be given plenty of room for individual development, both professionally and personally.

Benefits

About Ajinomoto Cambrooke

Ajinomoto Cambrooke, Inc. formerly Cambrooke Therapeutics, Inc. (expansion of Cambrooke Foods) was founded in 2000 by Lynn and David Paolella, the parents of two children diagnosed with a rare disease called phenylketonuria (PKU). PKU is one of the few genetic diseases, which is managed almost entirely with nutritional intervention. The Paolellas’ goal in forming Cambrooke was simple - to develop improved nutritional therapeutic options for those with serious medical disorders.

Today, Cambrooke produces medical formulas and foods for the management of a variety of medical conditions and we are continually innovating new nutritional options targeted at a wide array of diseases.