Job Title : Reimbursement Specialist (Days)

Location : Beverly, MA

Duration : 13 weeks

Shift : Days : 8 : 30 am - 5 : 00 pm (8 hrs.)

Shift Notes : Mon - Fri

Job Responsibilities :

• Work credit balances for any financial class and insurance grouping including Self Pay, Commercial, Federal, and State insurance plans.
• Work and track refunds via the refund portal for the states that require live checks.
• Identify and process credit balances by state (as required) by voiding in the applicable insurance portal, subject to management pre-approval.
• Appropriately identify, address, submit, and process credit balance adjustments.
• Understand and interpret Explanation of Benefits (EOB) / Remittances.
• Responsible for reviewing and addressing incoming mail correspondence.
• Effectively communicate and collaborate with all levels of staff / management and other internal departments.
• Complete and maintain facility reports regularly and review for any issues.
• Answer phone calls from patients, insurance companies, and collections agencies and manage refund requests according to processes and procedures.
• Follow up on returned / voided checks.
• Meet 30-day credit review expectations and document all claim follow-up / activity within the billing system.
• Maintain expected daily / weekly productivity by completing work assignments and taking proper actions to resolve open credit balances.
• Provide coverage for other Overpayment Specialists when necessary.
• 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 insurance updates.
• Maintain strict confidentiality of patient personal information.
• Maintain HIPAA compliance.
• Understand the business implications of decisions.
• Perform other tasks, duties, and projects as requested by Management.

Job Requirements :

• Bachelor’s degree with a focus in business or healthcare management - REQUIRED
• Dialysis or healthcare experience- REQUIRED
• Proficiency in Microsoft Office Suite- REQUIRED
• Knowledge of Excel, PivotTable and VLOOKUP- REQUIRED

Last updated : 2024-05-14