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Job: Reimbursement Specialist - 161884

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Posted: 09/13/2017

Job Reference #: 8a7880665da17d85015dbd5260b10959

Job Description

Summary: The Reimbursement Specialist performs administrative and reimbursement functions at the regional billing office. This position oversees the accounts receivable functions including qualification of appropriate documentation and billing. Ensures compliance with all government, contract, and company policies and regulations. Identifies payment trends and helps to coordinate collection activities. Identifies denial trends and corrects situation.
 
Essential Duties and Responsibilities include the following.  Other duties may be assigned. 
 
  • Prepare and handle billing for accounts to ensure timely reimbursement 
  • Identify insurance requirements including DMERC and Medicaid qualifications needed to ensure payer requirements are met 
  • Verify balances and receipts of all cash payments
  • Research overdue accounts and follow up by mail and/or phone to insurance carriers or customers on delinquent payments
  • Review claims denied for payment or underpaid claims 
  • Resubmit claims with proper documentation for further carrier review 
  • May coordinate collection activities for delinquent accounts by preparing information for collection agencies
  • Post payments and service dates to accounts to ensure accurate payment status and accurate account activity
  • Research unidentified payments using internal sources, written communication or phone inquiries to determine appropriate accounts to post payments 
  • Respond to customer inquiries regarding account status in a timely manner 
  • Research customer accounts thoroughly and documents appropriately 
  • Resolve discrepancies and prepare adjustments and refunds as necessary
  • Audit incoming paperwork for completeness and accuracy to ensure proper documentation for billing purposes
  • Records batches received and documents errors 
  • Brings recurring issues to the attention of management
  • Maintain accurate and current data files on all accounts
                                               
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
 
Education/Experience: High school diploma or GED equivalency.  Minimum of two years reimbursement and/or insurance experience preferred.  Infusion, Home Health, or DME experience preferred.  Strong interpersonal, communication, and organizational skills.
 

Application Instructions

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