Billing Reimbursement Specialist

Billing Reimbursement Specialist
Reimbursement Specialists are responsible for various functions in Billing department and should include a firm knowledge in billing, collections, charge posting, insurance eligibility and how insurances pay, as well as identifying and understanding credit balances. The Reimbursement Specialist will utilize the knowledge in these areas to perform unpaid/underpaid claim follow-up, resolve clearinghouse rejections, to rebill claims and to resolve customer billing inquiries and issues. The role will also include other duties and special projects as assigned by the Billing Supervisor.
Duties

Understand key tasks in the Billing, Collections, Cash Posting, Charge Posting, Credit Balance and Insurance Eligibility teams.

Identify payor denial reason via EOB or phone call and perform appropriate follow-up to resolve.

Provide any necessary verbal or written appeals to the insurance company.

Contact insurance companies on unpaid/underpaid claims to determine reasons for non-payment or underpayment, and how best to resolve.

Answer all inbound patient and escalated calls within five seconds, and provide excellent customer service while working with the caller to resolve the inquiry or issue.

Assist in the management and resolution of inquiries from other departments about patient accounts and orders.

Respond to coaching opportunities during scheduled and ad hoc one-on-one meetings with Team Lead/Manager/designee

Research and respond to requests for additional information via email and system generated tickets.

Maintain records of requests and resolution in order to monitor timeliness and accuracy of responses

Effectively utilize Excel and other system tools to maximize efficiency
Good computer application skills, specifically MS Excel; Brightree software experience preferred
Strong claim accounting and problem solving skills Understanding of a volume-based production environment
Experience: 3 year(s) required in Insurance Billing Collections Credits or documentation.
5 year(s) preferred in Healthcare Reimbursement.
Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is frequently required to sit and occasionally required to stand; walk; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
Job Type: Full-time


Required experience:

Reimbursement: 1 year

Medical Billing: 1 year


Staffmark is committed to providing equal employment opportunity for all persons regardless of race, color, religion, sex, sexual orientation, gender identity, age, marital status, national origin, citizenship status, disability or veteran status.

Requirements



Qualifications

Education: High School Diploma/GED

Clarity and accuracy in documenting work performed DME experience preferred

Experience billing insurance companies in numerous states preferred
Required education:

High school or equivalent