Reimbursement Analyst
About The Position
Reimbursement Specialist performs electronic and paper billing functions to submit claims. Performs computer edits and verifies data to ensure timely payment from the insurance carriers. Follow up with Medicare, Medicaid and/or Commercial payers regarding inappropriate discounts, unpaid claims, denials and questions regarding procedures. Department: Managed Care and Denials Hours: Full-Time, 40 hours a week required Location: Charleston, IL Required: High School Diploma Pay: Based on experience, starting at $21.62 Responsibilities Acts as a liaison between third-party payers and the organization., Answers telephone/mail inquiries dealing with patient’s insurance carriers., Assists in other areas as requested., Billing and collections for all SBL service lines., Builds new and maintains existing contract terms in contract management system., Coordinate coding issues to assure accuracy with the coding compliance department., Develops and maintains routine payer audits at regular intervals., Ensures that reimbursement is maximized in accordance with payer contracts., Follow up with payers regarding inappropriate discounts, unpaid claims, denials, and questions regarding procedures., Identifies problem delinquencies and makes recommendations for their disposition (e.g., referral to collection agencies, write-off, etc)., Process claims through billing system assuring the accuracy of claim information., Processes patient statements, chart documents, and patient demographics., Provides feedback on payer issues., Researches, identifies and corrects special circumstances affecting delayed payments of accounts., Researches contracting and payment issues and interacts with payers as a part of that process., Researches overpaid credits on patient accounts so that refunds can be made to the appropriate party in a timely manner., Responsible to understand and interpret reimbursement methodologies, billing and medical language so that effective and efficient analysis is provided., Review payment vouchers for adjustments that have not been completed or that are incorrect., Stay abreast of all government regulations by referencing publications, memos, websites, and attending seminars when offered. , Stays informed of statutes and regulations, which could affect collection of receivables (e.g., insurance company changes, collection regulations, etc)., Works variance work queues, identifying paper trends regarding the variance between actual and expected reimbursement for both facility and professional charges. Requirements High School (Required) Compensation Estimated Compensation Range $21.62 - $33.51 When you come to work for Sarah Bush Lincoln or Fayette County Hospital Long Term Care, you have our commitment to help make this the best work experience of your life. Career development is available through continuing education and on-site training, so come grow with us! We are striving to be the employer of choice in the area. Employees reap the benefit of our work culture which is steeped in professional and personal development programs. We have developed a solid benefit package to help retain our employees, while providing them opportunities to grow their careers. We support on-site classroom learning programs and internet courses, and we have a generous tuition reimbursement program-- all designed to help staff achieve their goals.
Requirements
- High School (Required)
Responsibilities
- Acts as a liaison between third-party payers and the organization.
- Answers telephone/mail inquiries dealing with patient’s insurance carriers.
- Assists in other areas as requested.
- Billing and collections for all SBL service lines.
- Builds new and maintains existing contract terms in contract management system.
- Coordinate coding issues to assure accuracy with the coding compliance department.
- Develops and maintains routine payer audits at regular intervals.
- Ensures that reimbursement is maximized in accordance with payer contracts.
- Follow up with payers regarding inappropriate discounts, unpaid claims, denials, and questions regarding procedures.
- Identifies problem delinquencies and makes recommendations for their disposition (e.g., referral to collection agencies, write-off, etc).
- Process claims through billing system assuring the accuracy of claim information.
- Processes patient statements, chart documents, and patient demographics.
- Provides feedback on payer issues.
- Researches, identifies and corrects special circumstances affecting delayed payments of accounts.
- Researches contracting and payment issues and interacts with payers as a part of that process.
- Researches overpaid credits on patient accounts so that refunds can be made to the appropriate party in a timely manner.
- Responsible to understand and interpret reimbursement methodologies, billing and medical language so that effective and efficient analysis is provided.
- Review payment vouchers for adjustments that have not been completed or that are incorrect.
- Stay abreast of all government regulations by referencing publications, memos, websites, and attending seminars when offered.
- Stays informed of statutes and regulations, which could affect collection of receivables (e.g., insurance company changes, collection regulations, etc).
- Works variance work queues, identifying paper trends regarding the variance between actual and expected reimbursement for both facility and professional charges.
Benefits
- Career development is available through continuing education and on-site training
- Employees reap the benefit of our work culture which is steeped in professional and personal development programs.
- We have developed a solid benefit package to help retain our employees, while providing them opportunities to grow their careers.
- We support on-site classroom learning programs and internet courses, and we have a generous tuition reimbursement program-- all designed to help staff achieve their goals.
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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
