Reimbursement Specialist (San Jose, CR)

Coloplast Business Centre in San José, Costa Rica is a proud member of the global Business Centre, supporting Coloplast’s North American operations. We work closely with our colleagues in Szczecin, Poland, home to one of Coloplast’s largest and fastest-growing sites, with around 800 talented professionals. Together, we drive excellence across key business functions—creating a strong, collaborative foundation for Coloplast’s global success.

 

The role:

 

This role is responsible for ensuring the timely and accurate resolution of accounts receivable through effective claims processing, cash collections, and appropriate write-offs. The ideal candidate will demonstrate a strong understanding of medical billing, insurance verification, and payment posting. They will be capable of independently investigating and correcting claim denials, resubmitting claims, and processing appeals. This position requires a high level of attention to detail, excellent organizational skills, and the ability to collaborate across departments.

 

Responsibilities:

• Review, correct, and process claims for all payers, both electronically and manually
• Investigate and resolve claim denials, making corrections as needed
• Apply accurate contractual adjustments to resolve outstanding balances
• Respond to billing inquiries from patients and insurance representatives professionally and promptly
• Reconcile patient collections and deposits
• Identify and report denial trends; propose solutions to reduce future denials
• Process refund requests and ensure compliance with payer guidelines
• Maintain accurate and detailed documentation within patient account
• Process appeals, including online and paper submissions
• Submit outstanding accounts receivable daily per company protocol 
• Work claims exceptions (ERL rejections) through the clearinghouse each day
• Interpret Accounts Receivable and apply correct adjustments in accordance with accounting principles
• Provide outstanding service to patients, internal teams, and third-party payers
• Review and resolve aged held billing issues (e.g., sales orders not auto-confirming due to errors)
• Collaborate effectively across departments to gather and share necessary data
• Adapt to changes in a fast-paced, evolving work environment
• Position may require occasional cross-departmental support, including insurance verification and payment posting
• Comply with all HIPAA, legal, and ethical standards, including Advanced Code of Ethics
• Coloplast employees are required to conduct business to the highest ethical and professional standards; comply with applicable laws and regulations, the Advamed Code of Ethics on Interactions with Healthcare Professionals, and company policies.
• Occasionally, employees currently recognized as high performers through recent performance evaluations, or employees with current demonstrated productivity leadership compared to other employees on existing metrics may be asked to engage in overtime. (Major job functions)

 

 

Requirements:

• Fluent in English
• High school diploma
• Minimum of 3 years’ experience in collections
• At least 1 year of experience in healthcare billing, insurance verification, or U.S government medical programs (DME experience preferred)
• Strong knowledge of medical terminology and healthcare reimbursement processes
• Proficiency in reading and interpreting claim rejections and EOBs (Explanation of Benefits)
• Solid negotiation skills and proven track record in collections (Minimum qualifications of experience, degrees, etc.)

 

 

Recruitment details

Please apply online with your CV in English. 
We will review all applications continuously and invite selected candidates further to the recruitment process. We will close the offer down once we find the best match to the role. 

 

Pursuing an ambitious growth agenda, Coloplast develops and markets products and services that make life easier for people with intimate healthcare needs. Employing about 16.000 people and with products available in more than 143 countries, we are one of the world´s leading medical device companies. We are constantly growing our business and always looking for new ways to move forward – we explore, learn and look for new ways of doing things.

 

Coloplast is committed to being an inclusive organization, where people bring their differences to work each day, fulfil their potential and have a strong sense of belonging because – and not despite – of their differences. We therefore encourage all qualified candidates to apply regardless of gender, age, race, nationality, ethnicity, sexual orientation, religious belief or physical ability.

 

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