Medical Reimbursement
About The Position
The Medical Reimburse Specialist is responsible for the timely and accurate posting of EOB and other forms received through the lockbox to the Medical Billing system. Completes spreadsheets and balances work on a daily basis and resolves credit balances on the Medical Billing system via refund, takeback request or adjustment. Specific duties include, but are not limited to: Posts payments, adjustments, denials received through the lockbox daily with high accuracy. Analyzes and resolves credit balances on Medical billing system. Prepares and processes refund requests and take-back requests. Balances posting activity from Medical billing system, lockbox data and spreadsheets on a daily basis. Calls the insurance carriers or uses the web to find out the status of the claim using the aging's, ticklers and touch point reports as a guide. Researches EOB's that come in the mail with denials on them. Completes a spreadsheet weekly with any adjustments that need to be done and passed to Management. If there are credit balances all the EOB's have to be pulled and a check request form is given to Management for approval before a check is cut. Accurately logs and posts Adjustment Requests and Price Discount Forms. Processes, logs and posts telephone credit card payments.
Requirements
- High School Diploma or Equivalent Experience
- Must be able to read and understand an Explanation of Benefits, use Excel or other spreadsheet programs and understand basic statistical/mathematical computations.
Responsibilities
- Posts payments, adjustments, denials received through the lockbox daily with high accuracy.
- Analyzes and resolves credit balances on Medical billing system. Prepares and processes refund requests and take-back requests.
- Balances posting activity from Medical billing system, lockbox data and spreadsheets on a daily basis.
- Calls the insurance carriers or uses the web to find out the status of the claim using the aging's, ticklers and touch point reports as a guide. Researches EOB's that come in the mail with denials on them. Completes a spreadsheet weekly with any adjustments that need to be done and passed to Management. If there are credit balances all the EOB's have to be pulled and a check request form is given to Management for approval before a check is cut.
- Accurately logs and posts Adjustment Requests and Price Discount Forms. Processes, logs and posts telephone credit card payments.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Industry
Ambulatory Health Care Services
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
