Billing/Payor Reimbursement Specialist

Huron Regional Medical Center • Huron, SD

232d • Onsite

About The Position

The Billing/Payor Reimbursement Specialist ensures efficient management of the claims processing cycle by accurate and timely claim submission, payor follow-up, and correspondence with providers including insurance inquiries. The employee is responsible for maintaining information and understanding of payers to ensure accurate collection of information and to ensure complete and accurate claims processing results in accurate payment received timely. This position requires communication with all levels of the organization, and all communication must be clear, concise, and timely. The ability to work independently and have a strong initiative to stay abreast of payer changes is critical for this position. Successful candidates will produce results that ensure profitability by resolving high dollar accounts first, identifying root causes for process improvement, effectively communicating barriers with their immediate supervisor, and working collaboratively with others to proactively resolve complex problems, reconcile account balances, access customer portals, and work with cash application and billing to ensure account accuracy.

Requirements

• High school graduate or GED equivalent.
• One or two years of college or business school preferred.
• Strong computer experience preferred.
• Experience in third party insurance billing/follow up and collections.
• Demonstrates understanding of the healthcare revenue cycle.
• Ability to work in a fast-paced, changing, and high growth environment.
• Possesses and has the ability to apply critical thinking skills.
• Detail oriented with the ability to prioritize work.
• Possesses and demonstrates mathematical aptitude.
• Ability to communicate both verbally and in writing with patients, staff, and 3rd party payors.

Responsibilities

• Manage the claims processing cycle by ensuring accurate and timely claim submission.
• Conduct payor follow-up and correspondence with providers regarding insurance inquiries.
• Maintain knowledge of payers to ensure accurate collection of information.
• Ensure complete and accurate claims processing results in timely payment.
• Communicate effectively with all levels of the organization.
• Resolve high dollar accounts first and identify root causes for process improvement.
• Collaborate with others to proactively resolve complex problems.
• Reconcile account balances and access customer portals.
• Work with cash application and billing to ensure account accuracy.

Benefits

• Health insurance
• Dental insurance
• Vision insurance
• Life insurance
• 401(k) retirement plan
• Sick leave
• Paid time off

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED