Location: Malvern, PA (this location is NOT public-transportation friendly)
Monday – Friday: 8:30AM-5:00PM
3-6 month+ contract-to-hire
Reimbursement Specialist I
- Can perform two (2) out of the three (3) functions as defined below with direct supervision:
- Billing claims to payors
- Work acknowledgements and billing error reports
- Identify and resolve claim issues
- Timely and accurate application of all payor remittances to customer accounts.
- Reconcile against deposit detail to ensure that all transactions have been posted.
- Work with Finance, Payor Relations, and external customers to facilitate the resolution of discrepancies caused by over or short payments made by the payor.
Other Duties as Assigned
- Customer Service
- Interact with external/internal customers as necessary to resolve problems and expedite payments
- Obtain status of outstanding claims
- Problem Solving/Troubleshooting
- Follow-up on outstanding AR balances by utilizing system work queues
- Ensure timely and accurate processing of re-bills to the appropriate insurance companies.
- Provide detailed information regarding problem payors to management
- File Appeals
- Submit appeals based on denials from payor
- Provide suggestions for solutions to management
- High school diploma or equivalent; Bachelor’s Degree in Business Administration, Healthcare Administration or related field preferred
- Up to three years experience- Reimbursement Specialist I
- Computer experience required: Microsoft Office – Excel, Word, Outlook, PowerPoint
- Must be a self starter, detail oriented
- Strong mathematical skills
- Reimbursement/billing/collections experience in Medicare, Medicaid, Managed Care, and Third Party Insurance in the healthcare industry
- Knowledge in ICD9 and Procedures; benefit plans/eligibility; EOB’s/EOMB’s
- Experience working with authorizations, and medical terminology and/or healthcare/HIPAA-regulated environment is a plus
- Strong communication skills
- Ability to work independently as well as in team environment
- High level of customer service
- Positive attitude, mature, conscientious, and accountable
CardioNet - 8 months ago
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CardioNet wants to be as close as your next heartbeat. The company provides real-time outpatient cardiac monitoring and telemetry services...