Patient Financial Services Reimbursement Specialist I
About The Position
At Nuvance Health, we enjoy the benefits of a two-state system as we cultivate an inclusive culture where everyone feels welcomed, respected and supported. Together, we are a team of 15,000+ strong hearts and open minds. If you share our values of connected, personal, agile and imaginative, we invite you to discover what’s possible for you and your career. Summary: Coordinates and monitors all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable functions. Responsible for the assigned area�s claims submission, payment application, denial management, and account follow-up to ensure optimal reimbursement.
Requirements
- High School Diploma or equivalent.
- Data entry.
- Customer service experience required.
- Minimum Experience: six months
Nice To Haves
- Experience in billing and collections or Medical Office/Healthcare experience preferred.
Responsibilities
- Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up.
- Confirms electronic and hard-copy billing of any delinquent claims. Rebills and follow-ups of all delinquent claims.
- Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries.
- Advises other areas of updated insurance information and claim denials, i.e., registration.
- Follows through with education of rules and regulations in the managed care system, as well as State & Federal guidelines.
- Adjusts account balances to specific account needs.
- Maintains Contract Management reporting (i.e., payment errors, carve out billings) and updates any information as needed or requested by supervisor.
- Responsible for reviewing and resolving patient/insurance credit/debit balances and ensure proper communication is delivered to the patient.
- Adheres to all policies and procedures related to federal, state and department compliance for the position.
- Maintains and Model the Organization values.
- Demonstrates regular, reliable and predictable attendance.
- Performs other duties as required.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
