Reimbursement Specialist

Empath Health•Palm Harbor, FL

About The Position

Empath Health is seeking a detail-oriented Reimbursement Specialist to join its Patient Accounting Team. The role compiles, reviews, and processes billing and accounts receivable documents, insurance bills and payments, and prepares and maintains accounts receivable and patient service revenue records and reports. The specialist also follows up on rejected, denied, and returned claims to support payment collection from Medicare, Medicaid, and insurance providers.

Requirements

Associate degree with one year of previous billing or medical-office-related experience preferred.
Demonstrated experience in general healthcare billing practices.
Proficiency with billing software and Netsmart and HCHB EMR within three months of hire.
Knowledge of Medicare and Medicaid billing regulations.
Knowledge of medical terminology.
Strong interpersonal, communication, and customer service skills.
Strong computer skills, including proficiency with Microsoft Office Suite, database applications, and medical billing applications.

Nice To Haves

Associate degree with one year of previous billing or medical-office-related experience is preferred.

Responsibilities

Prepare, review, and submit monthly billings according to established procedures.
Match bills with census information, identify discrepancies, and review patient billing revenues for accuracy.
Record payments as received, reconcile cash receipts monthly, and maintain accounts receivable records and reports.
Review and correct accounts receivable bills and records before transmission or mailing.
Clear rejections, denials, and returned claims, and follow up as necessary to collect payments from Medicare, Medicaid, and insurance providers.
Complete billing audits to ensure accuracy and compliance.
Receive and respond to inquiries from insurance sources and Case Managers regarding patient status or updated authorizations.