Patient Financial Services Reimbursement Specialist I - (FT, Days)

Northwell Health•Danbury, CT

19h•Hybrid

About The Position

Coordinates and monitors daily Patient Financial Services functions, including billing compliance and accounts receivable. The specialist is responsible for claims submission, payment application, denial management, and account follow-up in an assigned area to support optimal reimbursement. The position is hybrid-remote and full-time, with Monday–Friday schedules listed as 7:00 a.m.–3:30 p.m. or 7:30 a.m.–4:00 p.m. The role processes claims and payments, follows up on delinquent claims, responds to patient and payer inquiries, and reviews and resolves account balances. It also involves maintaining contract management reporting, communicating updated insurance information and claim denials to other areas, and following applicable managed care, state, federal, and department policies and guidelines.

Requirements

High school graduate or equivalent.
Data-entry skills.
Customer-service experience.
At least six months of experience.

Nice To Haves

Experience in billing and collections.
Medical office or healthcare experience.

Responsibilities

Accurately process claims, payments, rejections, refunds, credit balances, and unapplied cash daily, and perform timely follow-up.
Confirm electronic and hard-copy billing of delinquent claims; rebill and follow up on all delinquent claims.
Respond to patient and payer inquiries, denials, correspondence, and telephone inquiries.
Advise other areas, such as registration, of updated insurance information and claim denials.
Provide education on managed care rules and regulations and applicable state and federal guidelines.
Adjust account balances to meet specific account needs.
Maintain Contract Management reporting, including payment errors and carve-out billings, and update information as needed or requested by a supervisor.
Review and resolve patient and insurance credit and debit balances, and ensure appropriate communication is delivered to the patient.
Adhere to federal, state, and department compliance policies and procedures applicable to the position.
Maintain and model the organization's values.
Demonstrate regular, reliable, and predictable attendance.
Perform other duties as required.