Billing and Reimbursement Specialist - Patient Financial Services Job Wyoming area,Michigan USA,Healthcare

Position: Billing and Reimbursement Specialist - Patient Financial Services * Days - 40hrs/wk

Billing and Reimbursement Specialist - Patient Financial Services
* Days - 40hrs/wk

Requisition #: req
11458

Shift: Days

FTE status: 1

On‑call:
No

Weekends:
No

General

Summary:

A Billing and Reimbursement Specialist is responsible for the accurate and timely billing, follow up and payment for assigned accounts. Responsible for complete resolution of all aspects of insurance payment for claims assigned. Goal is to assure prompt, accurate reimbursement for services rendered.

Requirements:

Minimum high school diploma or GED, with two years experience working in an accredited hospital or physician office preferred

EPIC or Revenue Cycle Certification a plus

Ability to work independently with minimal supervision

Good oral and written communication skills.

Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up.

Professional, business‑like appearance and demeanor

Recognizes and reports problems, errors and discrepancies to management

Shares information with co‑workers

Ability to contribute to team efforts

Ability to assist with training of new employees as needed

Essential Functions and Responsibilities:

Works closely with Hospital and/or Physician office staff to assure correct information is obtained for billing purposes.

Reviews claims daily, prior to submission to payers, for accuracy utilizing electronic billing software

Reviews and takes action on claims returned by payers, whether denied or underpaid

Ability to post payments and reconcile vouchers according to department standard workplan

Responsible to validate the payments and adjustments made on accounts are correct

Maintains daily work queues according to payer requirements, including late charges/credits, multiple visits in one day, 3‑day rule, changes in insurance coverage, and claim errors

Files claims to payers in a timely manner to assure prompt reimbursement

Prepares Medicare Bad Debts following CMS guidelines

Ability to analyze reports from third party vendors for self pay balances.

Responsible for quality and productivity standards established by management

Complete knowledge of payer guidelines, including utilization of payer websites and other tools

Other duties as assigned.

Category:
Admin & Clerical, Customer Service, Health Care

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