Reimbursement Specialist NovaSom
THIS JOB HAS EXPIRED JOB SUMMARY:
The Reimbursement Specialist is responsible for preparing and resubmitting claims for to insurance carriers to ensure timely follow ups on all claims.
This position assists with training of new hires and supports the Billing and Cash Application Representatives.
DUTIES AND RESPONSIBILITIES:
The essential functions of the position include, but are not limited to, the following duties:
Post payments from third party payors and patients onto the billing software.
Prepare accurate resubmissions to third party payers and patients.
Process all Explanations of Benefits and follow through with payers/patients for collection on claims.
Obtains information from carrier/patient when services billed are denied for reasons of insurance, demographic information and / or authorization.
Update applicable databases with insurance coverage verified benefits, including coverage effective dates, patient demographic information, emergency contacts, residence and deliver to address ( if different than residence), insured relationship if patient is not insured and any other applicable information required by software program in use.
Verify all appropriate admission forms
Responsible for reporting daily/weekly/monthly results to the Reimbursement Supervisor. This report should include numbers and amounts of claims submitted, dollars collected vs. goal and a report by month showing original A/R, cash collected, write-offs, documentation hold and ending A/R.
Adhere to all policies and procedures, with the most stringent attention to complying with all governmental and HIPPA mandated patient confidentiality regulations.
Identify and analyze reimbursement trends within the client they are working.
Identify any issues or problems with payers and the possible difficulties in presenting clean claims to them based upon submission requirements.
Perform other duties as assigned.
SKILLS AND EXPERIENCE:
Strong oral and written communication skills
High attention to detail
Ability to prioritize needs and function independently
Must be able to multi-task well and handle changes in a positive manner
Possess a working knowledge of Microsoft Outlook, Word, and Excel
High school diploma some college preferred
Three years of medical claims processing experience
Equivalent combination of experience and education
||Glen Burnie, MD |
THIS JOB HAS EXPIRED