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POST DATE 12/7/2019
END DATE 1/6/2020
JOB DESCRIPTIONJOB DESCRIPTION
This employee will hand a high volume of incoming calls.
The Reimbursement Specialist serves as the subject matter expert in all Reimbursement responsibilities. This position performs all accounts receivable functions including qualification of appropriate documentation and billing. Helps ensures compliance with all government, contract, and company policies and regulations.
* Checks and understand eligibility and verification requirements
* Reviews claims using basic understanding of insurance coverage and criteria to help determine appropriate steps to submit payable claim
* Researches overdue accounts and follows up by mail and/or phone to insurance carriers or customers on delinquent payments
* Reviews denied or unpaid claims to determine proper resolution
* Resubmits general claims with proper documentation for further carrier review
* Responds to inquiries regarding account status in a timely manner
* Understands billing software in order to review customer information and enter data
* Files appeals and grievances on denied claims or authorizations/documentation.
* Identifies payer trends and issues and escalates when
* Understands advanced Medicare/Medicaid qualifications to meet payer
* Resolve discrepancies and prepare adjustments and refunds as
* Reviews medical records for audit
* High school diploma or GED equivalency required
* Prefer 1 year home health, customer service, call center, insurance, or reimbursement experience
* Strong interpersonal, communication, and organizational skills required
* Must have basic computer and typing skills
Preferred Homecare is an equal opportunity employer, access and affirmative action employer. All qualified applicants will receive consideration for employment regardless of race, color, religion, creed, sex, age, national origin, protected veteran status, disability status, sexual orientation, gender identity or expression, marital status, genetic information, or any other characteristic protected by law. Preferred Homecare provides reasonable accommodations for qualified individuals with disabilities. Because Preferred Homecare believes in providing a safe work environment, we conduct drug and background checks in our recruiting/hiring processes. AA/EOE, M/F/Disabled/Veterans
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