Reimbursement Specialist II
Alternate Solutions Health Network•Kettering, OH
•Hybrid
About The Position
The Reimbursement Specialist is responsible for all collection aspects for assigned payors and confirms eligibility for payor types. The Reimbursement Specialist ensures prompt payments and claim processing. Functions of this role performed timely and accurately, affect patient satisfaction, and quality outcomes. The Reimbursement Specialist complies with all legal, Medicaid & private insurance and company rules and regulations.
Requirements
- High school diploma or equivalent.
- An Associate’s degree or equivalent experience required.
- Billing and Health Care experience is required
- Excellent oral and written communication skills.
- Proficiency in Microsoft Excel, Word, and Outlook.
- Detail oriented with ability to manage multiple responsibilities and ability to prioritize responsibilities.
- Demonstrate critical thinking and problem solving.
Responsibilities
- Collects and follows up on accounts for payment in full
- Sends all electronic and paper claim resubmissions or correct claims
- Makes recommendations to the Controller regarding difficult payors with regards to prompt payments, claims processing, and recognition of denial trends.
- Assists clients, their families and co-workers in understanding billing procedures and payment
- Corrects claims and rebills for payment
- Communicates with employees, clients and vendors in regards to services
- Proactively addresses billing challenges
- Understands and practices agency policies and procedures
- Continually improves practices
- Follows all legal rules and regulations
- Attends in-services, educational programs and meetings as necessary
- Other duties as assigned
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
Associate degree
