Reimbursement Specialist

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Full Time Admin, Farmville, VA, US 1 Attachments

4 days ago Requisition

Salary Range: $19.81 To $29.71 Hourly

Position:
Full-Time

Location:
Farmville, Virginia

Minimum Qualifications

Associate degree preferred and/or a minimum of three years of relevant experience.

Previous experience in billing, reimbursement, accounts receivable, collections, medical billing, or a similar setting preferred.

Strong Microsoft Office skills, particularly Excel, Word, and Outlook.

Experience with computer systems, data entry, filing, and general administrative duties.

Excellent oral and written communication skills.

Demonstrated organizational and time-management abilities.

General Description
Crossroads Community Services Board is seeking a detail-oriented and organized Reimbursement Specialist to join our Finance team. This position is responsible for billing, reimbursement, collections, and follow-up activities related to both consumer and insurance account balances.

The Reimbursement Specialist works closely with the Reimbursement/Accounts Receivable Coordinator and other agency staff to ensure accurate billing, timely follow-up, and proper resolution of reimbursement issues. This position is non-exempt under FLSA and is designated as Level Two under the HIPAA Privacy Rule.

The successful candidate must be organized, able to establish priorities, manage multiple responsibilities, and complete assigned tasks accurately and within established deadlines.

This position requires flexibility in scheduling and the ability to travel throughout the Crossroads CSB service area and occasionally attend meetings outside the area.

A valid Virginia driver's license and acceptable driving record are required.

Employment is contingent upon successful completion of required background screenings, which may include fingerprinting, Sex Offender Registry and Crimes Against Minors Registry checks, and any other screenings required by Crossroads Community Services Board.

Knowledge Preferred

• Community Service Boards’ reimbursement policy and procedures as promulgated by DBHDS fiscal/ reimbursement office.
• Computer operations related to reimbursement and billing systems with emphasis on Accounts Receivable.
• General office operations including secretarial/reimbursement operations.
• General collection policies and procedures to maximize fee collections (e.g. Debt Set Off).
• Confidentiality policies, procedures and regulations related to reimbursement functions as mandated by both internal policy and external governing bodies (e.g. HIPAA, Code of Virginia, etc.).
• The Health Insurance Portability and Accountability Act of 1996 (HIPAA) and the Department of Health and Human Services (DHHS) security and privacy regulations relate to the protection of confidential medical information and personal health information as required by law, professional ethics and accreditation requirements.

Essential Duties and Responsibilities

• Responsible for identification and follow-up of past-due consumer accounts.
• Identify accounts to be submitted to the Virginia Department of Taxation.
• Manage the tracking and submission of these accounts to the Virginia Department of Taxation.
• Execute monthly clinical service billing via electronic, paper, and direct data entry platforms.
• Partner with the Reimbursement/AR Coordinator to analyze and resolve daily third-party claim denials, including voiding, correcting or submitting appeals.
• Collaborate directly with insurance providers to analyze underpayments, overturn claims denials, and resolve payment variances to maximize revenue recovery.
• Assists with training…