Reimbursement Specialist Medical Reimbursement specialist with multi-specialty billing, coding and collections knowledge, must have the ability to keep up with the day to day billing, posting of charges, processing of claims accurately, effectively maintain the A/R, investigate claims issues, and stay afloat of any trends in order to make recommendations for process improvements. Reviews medical record documentation to select and sequence the appropriate ICD-9-CM diagnosis, ICD-9-CM procedure codes, ICD-10-CM and ICD-10-PCS as applicable to transition to ICD-10. Performs coding across multiple specialities. Applies all appropriate coding guidelines and criteria for code selections. Adheres to Company and Coding Compliance policies and procedures for the assignment of complete, accurate, timely, and consistent codes for diagnoses and procedures.
Essential Duties and responsibilities include:
Review and billing submissions of manual or electronic claims
Correct billing errors with timely resubmission
Review EOB’s/ ERA’s for any missed opportunities
Follow up on aged accounts receivables through final resolution
Balance bill secondary, tertiary insurance as well as patients
Follow up on payment errors, overpayments, low reimbursements, rejections and denials
Other duties as assigned based on billing, payment posting, demographic entry, to ensure company goals are met and a team environment is maintained
Description of physical environment: Our Central Billing Office is best described as a high work volume, small low traffic office. HIPPAA compliancy is our number one priority. We make every effort to maintain a happy comfortable work friendly environment. We have an open door policy and fully strive to maintain a healthy work life balance.
Relationships connected with this position: Our revenue cycle model is structured around being completely outsourced. Our company represents the Physician’s office and we pride ourselves in maintaining healthy relationships with all primary and secondary contacts such as, the payers, the provider reps, facility employees as well as with patients.