Summary
We are seeking a dedicated Reimbursement & Collection Specialist. In this position you are responsible for the follow up of claims & reimbursement from multiple insurance companies.
Essential Duties and Responsibilities
- Contacts payers & patient as appropriate for claim processing
- Verifies payments for accuracy
- Reviews patient insurance benefits to determine why the claim is unpaid/underpaid
- Contact insurance company to have claims reprocessed/reprices/adjusted
- Occasionally assists in auditing patient files for medical necessity to ensure medical necessity is met prior to billing
- Reports any payer trends preventing payment to Team Lead and Revenue Cycle Manager
- Ensures clear and concise written and verbal communication with both locations and payers
- Performs other duties as assigned
QUALIFICATIONS
Employment is contingent on
- DME/HME experience preferred
- Knowledge of Brightree preferred
Education and/or Experience
- High school diploma or GED equivalent
- One to three years of related prior billing/reimbursement experience
- Strong customer service background
Skills, Knowledge and Abilities
- Effective communication
- Knowledge of medicare regulations, LCD’s and guidelines
- Helpful, knowledgeable and polite while maintaining a positive attitude
- Interpret a variety of instructions in a variety of communication mediums
- Knowledge of Durable Medical Equipment (DME)
- Knowledge of insurance policies and requirements
- Knowledge of medical billing practices and of billing reimbursement
- Maintain confidentiality and practice discretion and caution when handling sensitive information
- Medical terminology
- Multi-task along with attention to detail
- Must be able to accurately perform simple mathematical calculations using addition, subtraction, multiplication and division
- Read and successfully interpret written directions and/or instructions in English
- Self-motivation, organized, time-management and deductive problem solving skills
- Sense of urgency and responsiveness to physicians, location employees and patients
- Work independently and as part of a team
Physical Demands
- Requires sitting, walking, standing, talking or listening; extensive hours sitting at a desk
- Requires close vision to small print on computer and or paperwork; extensive hours working on the computer
Machines, Equipment and Technical Abilities
- Email transmission and communication
- Internet navigation and research
- Microsoft applications including but not limited to Word, Excel, Power-Point
- Brightree system
Job Type: Full-time
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Life insurance
- Vision insurance
Schedule:
Application Question(s):
- What is your salary requirement?
Experience:
- reimbursement collection: 3 years (Preferred)
- DME: 3 years (Preferred)
Ability to Relocate:
- North Wales, PA 19454: Relocate before starting work (Required)
Work Location: In person