Reimbursement Specialist
CardioNet - Malvern, PA

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Reimbursement Specialist

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.
  • 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
Other Duties as Assigned

  • 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

Personal Attributes
  • 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 - 9 months ago - save job