We are currently supporting one of our top clients in their search for a Reimbursement Specialist. The Reimbursement Specialist duties include:
• Review patient files for completeness and accuracy, identify and audit claims, ensure all revenue opportunities are included, and complete and submit billing, primary and secondary, to payers for reimbursement, via paper bills and clearing house submittals.
• Analyze denials, identify trends and recommend process improvement opportunities that will result in DSO reduction, superior collection rate and intervals, reduced bad debt, and simplified processes that are responsive to the requirements of specific payers.
• Review claims with outstanding balances and identify actions to successfully collect revenues. Follow up with insurers and patients to collect outstanding balances in an environment of world-class customer service focused on building enduring customer and business relationships.
• Review documents received including Explanations of Benefits (EOBs), Remittance Advices (RAs) and other documents indicating denials or claims acceptance. Identify reasons for denials, take required corrective action, and take ownership of claims through to timely, successful collection.
• Document case activity, communications and correspondence in computer system to ensure completeness and accuracy of account activity and actions taken to resolve outstanding claims issues. Schedule follow-ups in required intervals.
• Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies and procedures to improve the efficiency and effectiveness of the Revenue Cycle Management team.
• High School Diploma or equivalent and additional specialized training in medical billing and / or collections.
• Minimum 2 years’ Medical Billing and/or Collections experience.
• Coding Course Certification is highly preferred.
• Some jurisdiction may require the ability to be fluent in English and Spanish