Patient Financial Services Reimbursement Specialist II

About the position

The Patient Financial Services Reimbursement Specialist II coordinates and monitors all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable functions. This role is responsible for the assigned areas' claims submission, payment application, denial management, and account follow-up to ensure optimal reimbursement. The position is full-time, with standard hours of 40 per week, working Monday to Friday from 8 AM to 4:30 PM.

Responsibilities

• Coordinates/monitors all aspects of billing/accounts receivable management; ensures compliance, efficiency & reimbursement; includes accurate & timely preparation/submission of claims, payment & rejection application & follow-up for receivables.
• Receives and processes payments & rejections for assigned work group accurately & timely. Performs trend analysis for management to determine registration & documentation deficiencies throughout the organization.
• Responsible for daily completion & correction of information for claims edit lists & rejections; identifies training issues within the department.
• Processes claims on a daily basis & performs timely follow-up. Supports Team Leader; ensures appropriate completion of department workflow.
• Offers guidance & training to lower level staff & provides input to Level I staff member's performance if requested.
• Provides feedback to designated Hospital contacts regarding billing and reimbursement issues & changes in procedures, rules & regulations.
• Participates in meetings with supervisors and/or managers to review issues including staff training & education, A/R management & reimbursement issues.
• Supports the Team Leader in monitoring the accuracy & completion of the entire cash application process.
• Adheres to all policies and procedures related to compliance with all federal & state billing & collection regulations & third party contractual obligations.
• Identifies and resolves problems associated with billing, procedures, system functionality, etc. and reinforces training for staff as necessary.
• Maintains departmental policies and procedures.
• Fulfills all compliance responsibilities related to the position.
• Performs other duties as assigned.

Requirements

• Data entry and MS Excel skills.
• Customer service experience required.
• Minimum of one year of experience in a related field.

Nice-to-haves

• Medical terminology knowledge.
• Experience in billing, cash applications, and collections.