Billing and Reimbursement Specialist - Patient Financial Services Days - 40hrs/wk

umhealthwest•Wyoming, MI

About The Position

A Billing and Reimbursement Specialist is responsible for the accurate and timely billing, follow up and payment for assigned accounts. Responsible for complete resolution of all aspects of insurance payment for claims assigned. Goal is to assure prompt, accurate reimbursement for services rendered.

Requirements

Minimum high school diploma or GED, with two years experience working in an accredited hospital or physician office preferred
Ability to work independently with minimal supervision
Good oral and written communication skills.
Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up.
Professional, business-like appearance and demeanor
Recognizes and reports problems, errors and discrepancies to management
Shares information with co-workers
Ability to contribute to team efforts
Ability to assist with training of new employees as needed

Nice To Haves

EPIC or Revenue Cycle Certification a plus

Responsibilities

Works closely with Hospital and/or Physician office staff to assure correct information is obtained for billing purposes.
Reviews claims daily, prior to submission to payers, for accuracy utilizing electronic billing software
Reviews and takes action on claims returned by payers, whether denied or underpaid
Ability to post payments and reconcile vouchers according to department standard workplan
Responsible to validate the payments and adjustments made on accounts are correct
Maintains daily work queues according to payer requirements, including late charges/credits, multiple visits in one day, 3-day rule, changes in insurance coverage, and claim errors
Files claims to payers in a timely manner to assure prompt reimbursement
Prepares Medicare Bad Debts following CMS guidelines
Ability to analyze reports from third party vendors for self pay balances.
Responsible for quality and productivity standards established by management
Complete knowledge of payer guidelines, including utilization of payer websites and other tools
Other duties as assigned.