Sr. Contract Reimbursement Representative (H)

University of Miami • Medley, FL

6d

About The Position

The University of Miami/UHealth Central Business Office is hiring a full-time Contract Reimbursement Representative in Miami, Florida. The role is responsible for ensuring accurate reimbursement practices and identifying and reporting issues. The representative reviews and resolves credits, interprets contract rates and explanations of benefits, handles reimbursement inquiries and refund requests, processes refunds, and provides training to onboarding staff and vendors.

Requirements

• High school graduate.
• One year of medical billing and collections experience.
• Excellent verbal and written communication skills in English.
• Strong organizational skills and the ability to multitask and handle difficult situations.
• Knowledge and understanding of state and federal hospital regulations and medical terminology.
• Excellent critical-thinking, analytical, problem-solving, interpersonal, communication, and customer-service skills.
• Ability to work under minimal supervision, function in a high-stress environment, multitask, and establish priorities.
• Knowledge of Medicare, Medicaid, managed care, third-party payer systems, and Florida Prompt Pay Law.
• Ability to maintain a professional demeanor when communicating with staff, patients, and outside contacts.
• Ability to maintain the confidentiality of patient information.

Nice To Haves

• EPIC experience.

Responsibilities

• Review and analyze credits in assigned work queues and resolve them appropriately, involving payers, patients, and other entities.
• Review and interpret contract rates and explanations of benefits to ensure proper reimbursement.
• Act as a liaison between the Credit Balance Unit and external departments, vendors, patients, and third-party companies on reimbursement-related inquiries.
• Review payer and patient refund requests for validity and submit appeal letters within the allotted time.
• Apply Florida statutes to commercial payers.
• Assess patient coverage, eligibility, and pre-authorizations.
• Process refunds by check, credit card portal, and wire transfer.
• Provide ongoing in-service training for onboarding staff and vendors.

Benefits

• Competitive salaries.
• Medical benefits.
• Dental benefits.
• Tuition remission.
• Additional benefits.

What This Job Offers

• Job Type: Full-time
• Education Level: High school or GED