Reimbursement Specialist - 161963 9/19/2017
Preferred Homecare / Lifecare Solutions
JOB DESCRIPTIONAPPLY Reimbursement Specialist (Medicare Collections)
Position Summary: The Reimbursement Specialist performs administrative and reimbursement functions at the regional billing office; 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; preferable Medicare or DME knowledge; proficient with basic mathematical skills, detail oriented, ability to multi-task, and ability to problem solve.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Prepare and handle billing for accounts to ensure timely reimbursement
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
Able to handle a high call volume, in a call center environment resolving patient billing issues, and payments.
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 organization
Mental Demands: Proven skills in critical thinking and problem solving, strong analytical, numerical and reasoning abilities. Detail oriented and responsible. Flexible and innovative thinking. Uses good judgment and works well under pressure. Able to prioritize and handle multiple tasks.
Physical Demands: Occasional climbing, balancing, stooping, and crouching. Frequent standing, walking, and sitting. Must be able to occasionally lift 10 pounds.
Materials and Special Equipment used: Telephone, computer, printer, fax machine, photocopier, and calculator.
Environmental Conditions: Work is generally performed in normal office conditions, with good lighting and proper ventilation.
As an EEO/Affirmative Action Employer, all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, veteran or disability status. View more information about Equal Employment Opportunity at the following URL : http://www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf