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This position can be in office, hybrid or remote!
The Overpayment Specialist (OVPS-I) is assigned a group of credit balances and is responsible for accurately and efficiently resolving the open claims.
Additionally, this individual will review EOB's, contracts and / or other supporting documentation to determine if payments need to be refunded or if balances can be adjusted in accordance with policies and procedures, including federal, state and local standards, guidelines, and regulations.
Work credit balances for any financial class and insurance grouping including Self Pay, Commercial, Federal and State insurance plans.
2. Work and track refunds via refund portal for the states that require live checks.
3. Identify and process credit balances by state (as required) by voiding in the applicable insurance portal, subject to management pre-approval.
4. Appropriately identify, address, submit and process credit balance adjustments.
5. Understand and interpret Explanation of Benefits (EOB) / Remittances.
6. Responsible for reviewing and addressing incoming mail correspondence.
7. Effectively communicate and collaborate with all levels of staff / management and other internal departments.
8. Complete and maintain facility reports on a regular basis and reviews for any issues.
9. Answer phone calls from patients, insurance companies and collections agencies and manage refund requests according to process and procedures.
10. Follow up on returned / voided checks.
11. Meet 30-day credit review expectation and clearly document all claim follow up / activity within the billing system.
12. Maintain expected daily / weekly productivity by completing work assignments and taking proper actions to resolve open credit balances.
14. Gain knowledge of billing requirements by reviewing insurance contracts and understanding billing language and rates.
Maintain knowledge of payer guidelines and procedures by staying up to date with insu rance updates.
15. Maintain strict confidentiality of patient personal information.
16. Maintain HIPAA compliance.
17. Understand business implications of decisions.
18. Perform other tasks, duties and projects as requested by Management.
Requirement description :
Weekend Requirements : No Weekends
On Call Requirements : No Call
Last updated : 2024-04-28
Full Time
$50k-61k (estimate)
04/28/2024
05/05/2024
The job skills required for Reimbursement specialist include Billing, Microsoft Office, Communicates Effectively, HIPAA, Confidentiality, etc. Having related job skills and expertise will give you an advantage when applying to be a Reimbursement specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Reimbursement specialist. Select any job title you are interested in and start to search job requirements.
The following is the career advancement route for Reimbursement specialist positions, which can be used as a reference in future career path planning. As a Reimbursement specialist, it can be promoted into senior positions as a Staff Nurse - RN, Sr. - Medical Management that are expected to handle more key tasks, people in this role will get a higher salary paid than an ordinary Reimbursement specialist. You can explore the career advancement for a Reimbursement specialist below and select your interested title to get hiring information.
If you are interested in becoming a Reimbursement Specialist, you need to understand the job requirements and the detailed related responsibilities. Of course, a good educational background and an applicable major will also help in job hunting. Below are some tips on how to become a Reimbursement Specialist for your reference.
Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Reimbursement Specialist job description and responsibilities
Reimbursement specialists utilize reference materials and medical coding knowledge to address claims.
04/22/2022: Frankfort, KY
Step 2: Knowing the best tips for becoming an Accountant can help you explore the needs of the position and prepare for the job-related knowledge well ahead of time.
Career tips from people on Reimbursement Specialist jobs
The career path for a reimbursement specialist starts by first obtaining a high school diploma or GED.
05/26/2022: Boca Raton, FL
Educational prerequisites for reimbursement specialists vary, from a minimum of a high school diploma to a bachelor’s degree.
04/27/2022: New York, NY
Step 3: View the best colleges and universities for Reimbursement Specialist.