Reimbursement Specialist

Position Summary: 

Works to ensure reimbursement and collections for patients’ treatment expenses and also keeps track of accounts receivable and billing invoices while communicating with individuals or insurance companies to obtain reimbursement.

Working Conditions: 

Position is in an office environment and requires full range of body motion, as well as manual and finger dexterity and eye-hand coordination. Sedentary, sitting, walking, occasional lifting (overhead, waist level) from floor, bending, frequent near vision use for reading and computer use. Will occasionally be asked to lift and carry items weighing up to 30 pounds. Normal visual acuity and hearing are required.

Primary duties include, but are not limited to:

  1. Works with insurance companies to verify patient eligibility, process patients claims, and ensure payments are received properly.
  2. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted.
  3. Processes charge ticket reconciliation and end of day balancing.
  4. Processes co-pay insurance collection
  5. Assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation.

Position Requirements:

  1. High school diploma or equivalent
  2. 3 years of related experience
  3. Experience in coding ICD-10 and CPT
  4. Experience with account ledgers
  5. Working knowledge of Medicare/Medicaid
  6. Effective interpersonal skills
  7. Excellent verbal and written communication skills
  8. Familiar with medical knowledge and terminology
  9. Ability to multi-task, self-motivated, team player, and attention to detail

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EEO/M/F/V/D Employer