2 Reimbursement Specialist Jobs in Houston, TX
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Tad PGS, Inc is Hiring a Reimbursement Specialist Near Houston, TX
- Maintain a complete collection of accounts receivable for area of expertise. This includes following accounts through the revenue cycle, from charge review, claim edits, claim submission, and follow up with third party payers and patients to facilitate prompt resolution of outstanding account balances.
- Resolve claim edits via claim edit work queues and/or our external billing software.
- Review charges to ensure accurate filing to correct guarantor.
- Analyze and reconcile denied payment transactions.
- Compile and file all information needed to appeal denials.
- Follow federal and state regulations to ensure compliance standards are met.
- Monitor timely filing requirements on claims and appeals.
- Follow-up with contracted payers to secure payments on outstanding balances.
- Evaluate third party payments to ensure accuracy relative to contract language (underpayment/overpayment).
- High School Diploma or equivalent combination of education/work experience.
- Minimum 3 years of experience in a healthcare revenue cycle or clinic operations role.
- Xifin experience.
- Three years of experience in a healthcare revenue cycle, specific to area ofexpertise (I.e. IDTF, Trans telephonic.
- Electronic Monitoring Service (e.g., 24-hour ambulatory EKG monitoring, pacemaker monitoring and cardiac event detection) or client billing
- Sitting for extended periods of time will be required.
- Use of hands repetitively to type, handle and operate standard office equipment will be required.
- Employee will work under typical office conditions.
- Ability to use various computer applications including Xifin.
- Excellent PC operating skills (keyboard, mouse) and use of MS Office.
- Broad knowledge of health care business office practices and principles.
- Basic math skills and knowledge of general accounting principles.
- Knowledge of medical and insurance terminology, CPT, ICD coding structures, and billing forms (UB, 1500).
- Maintain confidentiality of sensitive information.
- Associate degree in Business, Finance, Health Information Management, or related field.
- 5 Years Prior Medical Collections Experience.
- Knowledge of claims processing and adjustments.
- Knowledge of Medicare, Medicaid, and Commercial carriers.
- Excellent communication and organizational skills.
- Ability to calculate insurance benefits and write appeal letters (using templates).
- Ability to read and understand Explanation of Benefits.
- Knowledge of Out of Network (Non-participating provider) Collections
- Insurance verification.
- Knowledge of Centricity.
- Basic Benefit Coordination.
- Knowledge of Medicaid or Medicare Claim Processing regulations.
Job Summary
Full Time
$53k-68k (estimate)
02/09/2024
04/05/2024
tadpgs.com
Bradenton, FL
200 - 500
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The job skills required for Reimbursement Specialist include Billing, Accounting, CPT, Health Care, Problem Solving, Accounts Receivable, 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.
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