Reimbursement Specialist

Bronson Healthcare • Battle Creek, MI

264d

About The Position

The Reimbursement Specialist performs duties necessary to facilitate payment from third party payers. This includes correct billing, status updates, and collection from third parties, posting third party payments (if applicable), inputting correct reimbursement, processing incoming and outgoing correspondence, and maintaining a working knowledge of current contracts and government regulations for multiple entities. Employees providing direct patient care must demonstrate competencies specific to the population served.

Requirements

• High school diploma or general education degree (GED) required.
• Associate's degree in business or Finance; or equivalent experience in Medical Billing, Receivables or Collection preferred.
• Successfully pass EUPA's for all Epic applications associated with position within the first 90 days.
• Strong computer and general office equipment knowledge required.
• Knowledge of medical terminology, ICD-9 and CPT-4 coding preferred.
• Ability to type 45 words per minute is necessary.
• Effective communication skills with patients, customers, and co-workers.
• Ability to quickly analyze communication style based on verbal inquiry.

Nice To Haves

• Knowledge of third-party payers, managed care, reimbursement, and regulatory compliance preferred.

Responsibilities

• Facilitate payment from third party payers through correct billing and collection.
• Post third party payments and input correct reimbursement.
• Process incoming and outgoing correspondence.
• Maintain knowledge of current contracts and government regulations.
• Ensure claims are compliant with all payer specifications, State, Federal, and HIPAA regulations.
• Resolve billing issues to promote better reimbursement and reduce outstanding revenue.
• Prepare documentation to maximize reimbursement.
• Analyze assignment of all CPT-4, ICD-9, UB04, HCFA 1500 codes for accuracy.
• Critically analyze and process third party and internal information requests and rejections.
• Make necessary postings, adjustments, and refunds to accounts.
• Understand and apply current contracts and governmental regulations.
• Verify insurance eligibility using automated online systems.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Industry: Hospitals
• Education Level: High school or GED