Remittance Reimbursement Specialist

PRIMARY RESPONSIBILITIES:

• Ensure timely and accurate posting of all electronic and paper payments, denials and correspondence from patients and insurance companies
• Identify underpayments and overpayments made by patients and third-party payers while monitoring the credit balance report
• Process all credit card transactions
• Resolve unapplied reports in a timely manner and contact insurance companies for payment and patient information to help identify payments which cannot be applied
• Certify the review and timely submission of all patient refunds
• Review adjustments for accuracy
• Download and logs bank deposits, verify batch totals, reconcile, and update payment batches
• Recognize and locate remittance advice and Explanation of Benefits (EOBs) from payer websites
• Identify insurance contract opportunities/requirements and communicates to the Payor Relations department
• Process, sort, and direct incoming and outgoing mail to the appropriate teams and departments
• Maintain patient accounts by appropriately notating, updating, and collecting patient demographic, and insurance information
• Provide management team with immediate feedback on issues affecting workflow, reimbursement, and customer service
• Adhere to appropriate quality control, confidentiality, and HIPAA guidelines
• Attend staff meetings and report on monthly performance and activities
• Supply excellent customer service, whether to inside stakeholders or external customers/contacts

QUALIFICATIONS, SKILLS & COMPENTENCIES:

• Bachelor’s degree, preferred
• 3 years in customer service, insurance verification and insurance billing, required
• Previous experience with cash posting, medical claims processing, insurance verification, medical records and insurance terminology
• Competency with Windows PC Applications, including strong Microsoft Word and Microsoft Excel skills
• Strong keyboard and navigation skills and ability to learn new computer skills & applications
• Ability to handle multiple tasks and accurately process high volumes of work, while prioritizing work and managing time effectively to meet deadlines
• Capable of making decisions and solving problems using established departmental standard operating procedures and guidelines with limited supervision
• Demonstrated effective and appropriate communication styles and interpersonal skills that promote positive and professional working relationships with peers and management team
• Ability to assist with and adapt to departmental and / or company procedural changes
• Able to work a 40-hour schedule within the operating hours of the department, 8 AM to 9:30 AM start time and ending 5:00 PM to 6:30 PM
• It may be necessary, based on business and departmental need, to work occasional overtime and/or weekends.
• Telecommute work possible, subject to business environmental conditions

BENEFITS:

• Competitive salary and bonus structure
• Health, dental and vision insurance as well as other ancillary benefits
• Retirement savings plan – 401(k) – with company match
• Paid time off (PTO) and holidays
• Professional development and training opportunities
• Employee wellness programs

EEO STATEMENT:

RMX Monitoring, LLC.  is an equal opportunity employer who openly supports and fully commits to recruitment, selection, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state, and/or local laws.  Inclusion and diversity amongst our teams is essential to our success.