Reimbursement Specialist (Skilled Reimbursement)

>> We offer our team the best <<

• Medical, Dental and Vision Benefits
• Continued Education
• PTO Plan
• Retirement Planning
• Life Insurance
• Employee discounts

Position Summary: The Reimbursement Specialist (Skilled Reimbursement) will be responsible for billing and revenue cycle management thorough insurance benefit investigation of new referrals, assignment of collections with a variety of payers, authorization requests, and claim submissions. Must have experience in CPT/HCPCS, Medicare Part B Billing, review claims, submit claims and work clearinghouse responses as well as auth/eligibility.

Schedule: Monday-Friday 8am to 5pm Central Standard Time (Remote)

Essential Duties:

• Accurately interprets patient insurance, prescription and other health-related documentation
• Conducts medical insurance verifications and investigations for commercial and government payors
• Communicates with insurance companies, patients, providers and prescribers to coordinate reimbursement and access solution
• Reviews unpaid accounts to determine status and taking appropriate action to ensure payment.
• Reviews all claims for compliance and completeness for claims submissions.
• Researches available alternative funding options to reduce patient’s financial burden
• Handles high call volumes
• Communicates with internal and external departments to facilitate coordination of care
• Maintains a high degree of confidentiality at all times due to access to sensitive information
• Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
• Follows all Medicare, Medicaid, and HIPAA regulations and requirements
• Abides by all regulations, policies, procedures and standards
• Performs other duties as assigned

Position Requirements & Competencies:

• High school diploma or equivalent is required; Undergraduate degree is preferred
• Medicare Part B billing, HCPCS/CPT codes and well as auth and eligibility and familiar with Waystar or clearinghouse processes/responses
• Experience in Medical Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment is preferred
• Possess quick and accurate Alpha/numeric data entry skills
• Computer proficiency – MS Office and Web-enabled applications strongly preferred
• Customer service skills required.
• Understanding of the requirements of Medicaid, Medicare and Insurance billing is preferred
• Maintains positive internal and external customer service relationships
• Maintains open lines of communication
• Plans and organizes work effectively and ensures its completion
• Meets all productivity requirements
• Demonstrates team behavior and promotes a team-oriented environment
• Actively participates in Continuous Quality Improvement
• Represents the organization professionally at all times
• Self-starter with exceptional organizational and follow-through skills
• Excellent verbal and written communication skills
• Ability to work independently and in a team environment

To apply via text, text 9199 to 334-518-4376

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