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 Graduate or Equivalent required
- Data entry and customer service experience preferred.
- Six months minimum experience in billing and collections is preferred
- 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�s values.
- Demonstrates regular, reliable and predictable attendance.
- Performs other duties as required.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
Number of Employees
1,001-5,000 employees
