Patient Financial Services Reimbursement Specialist II

Nuvance HealthDanbury, CT
23d$21 - $30

About The Position

The Patient Financial Services Reimbursement Specialist II plays a vital role in managing the complete lifecycle of patient financial accounts�from initial creation through final resolution. This position ensures seamless claims processing, accurate payment application, and effective denial management while maintaining compliance with billing regulations. With a strong focus on optimizing reimbursement, the specialist proactively monitors accounts, facilitates timely follow-up, and collaborates with internal and external stakeholders to resolve outstanding balances. Their expertise supports the organization�s financial integrity and enhances the overall patient experience by ensuring a smooth and efficient reimbursement process.

Requirements

  • High School Diploma or equivalent.
  • Data entry and MS Excel.
  • Customer service experience required.
  • Minimum Experience: one year

Nice To Haves

  • Medical terminology, billing, cash applications and collection experience.

Responsibilities

  • Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up.
  • Responsible for daily completion and correction of information for claims edit lists and rejections.
  • Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries.
  • Provides immediate access to explanation of benefits (EOB's), reports and other information as requested.
  • Offers guidance and training and provides performance input to Level I staff member's if requested.
  • Supports the Team Leader in monitoring the accuracy and completion of the cash application process.
  • Identifies departmental problems associated with procedures, system functionality, staff training and education, and reimbursement issues. Makes recommendations to management for improvement and resolution.
  • Performs trend analysis for management in order to determine registration & documentation deficiencies throughout the organization.
  • 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.
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