Essential duties and responsibilities:
The Reimbursement Specialist will be responsible for proper and timely posting of payments to patients accounts. This includes reviewing and analyzing electronic remittance, receiving payments, and interpreting payor contracts to determine appropriateness in reimbursement.
SUPERVISION RECEIVED: Revenue Cycle Management.
SUPERVISION EXERCISED: None
ESSENTIAL FUNCTIONS:
Critical to this position is a knowledge of billing and medical reimbursement procedures and ability to interpret electronic remittance/correspondence from insurance companies.
DUTIES AND RESPONSBILITIES:
- Posting payments, adjustments and notes from electronic remittance.
- Receiving patient inquires and processing payments on open accounts.
- Reconciling, labeling and closing posted batches with control sheet on a daily basis.
- Preparing EOB for posting according to departmental policy.
- Identifying, analyzing and addressing reimbursement issues (i.e., incorrect adjustments, underpayments).
- Ensuring managed care/insurance contracts are processing in accordance with contract language and associated fee schedules.
- Responsible for coordinating activities with Collection agency.
- Assisting Revenue Cycle team as needed.
- Performs other duties as assigned.
QUALIFICIATIONS:
- High school diploma or GED
- 1-2 years’ experience in physician billing/payment posting; experience working in physician practice preferred.
- Knowledge of eCW
- Demonstrated oral and written communication skills.
- Ability to show professionalism when communicating with staff and vendors.
PHYSICAL/MENTAL DEMANDS:
- Frequent mobility and/or sitting required for extended periods of time.
- Manual dexterity for using a calculator and computer keyboard.
- Some bending and stooping required.
- Moderate to high volume of calls.
ENVIRONMENTAL/WORKING CONDITIONS:
- Work is performed in a busy office environment and requires desk work.
- Frequent contact with employees and outside agencies.
- Continual patient contact may involve dealing with angry or upset people.
- Continually required to talk or hear
- Occasionally required to stand or walk
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities,
knowledge, skills, abilities and working conditions may change as needs evolve and to reflect the on-going changes in office.