Reimbursement Specialist

Summit Orthopedics•Woodbury, MN

2d•Hybrid

About The Position

At Summit Orthopedics, we recognize the significance each member of the Summit Family has as they impact one another and our patients on a daily basis. Be part of a patient-first environment that lives into our values of: Compassion, Integrity, Excellence, Collaboration, Stewardship and Innovation and a place where staff members feel respected and find a strong sense of purpose in their roles, contributing to a familial atmosphere characterized by mutual respect and enjoyment. Under the direct supervision of the Reimbursement Manger, the Reimbursement Specialist will follow-up with the intent of collecting all delinquent unpaid insurance and patient account balances. This is a full-time position based at our Corporate Office located in Woodbury, MN. Monday - Friday schedule of 8:00 AM to 4:30 PM with the ability to work remotely once fully trained. (schedule subject to change).

Requirements

Knowledgeable in payer orthopedic and PT policies
Remain current with payer policies and protocols
Adherence to HIPAA regulations and patient privacy measures

Responsibilities

Work Systoc APM Work Queues on a daily basis in accordance with Business Office policies and procedures.
Knowledgeable in payer orthopedic and PT policies and remain current with payer policies and protocols, sharing information within organization.
Maintain account aging with emphasis on resolution of accounts more than 120 days from date of service.
Identify, research and resolve any issues preventing payment of accounts.
Communicate daily with insurance carriers, patients, medical office staff, and other third-party agencies to collect outstanding balances due, resolve disputes, denials, and general non-payment issues.
Provide support and backup for Customer Service.
Prevent timely filing denials by strict adherence to guidelines set by carriers for follow-up on initial claim filings and subsequent claim denials.
Work all patient and insurance carrier refunds within established parameters.
Act as backup to receipts area, posting payments to patient accounts, according to established policies.
Review and approve accounts for collection agency placement.
Perform due diligence in resolving outstanding balances ensuring all efforts have been exhausted in resolving issues with payers before writing off to bad debt, transferring to the next payer level or patient responsibility.
Effectively maintain a high level of professionalism when contacting patients, insurance carriers, facilities and clinics and other third-party agencies while adhering to HIPAA regulations and patient privacy measures.