Medical Insurance Reimbursement Specialist
This is a temporary to permanent position, with part time hours.
PART TIME hours.
Responsible to contact patients regarding accounts receivable balances and to follow-up and bring resolution to claims with specific denial reasons through appeal procedures.
Applies ICD-9, ICD-10, and CPT code knowledge to collection of claims and keeps current with changes in coding, payers, and insurance policies.
Interprets explanation of benefits including allowed amounts, discounts, in/out-of-network benefit levels, deductibles, coinsurances, and copays.
Responsible for the printing, scanning and mailing of all documents, with expectation of keeping all queues current on a daily basis.
Responsible for the processing and follow-up of all enrollments for new and existing clients.
Ensure that the enrollments are complete and accurate.
Ability to handle multiple PM systems including AR Aging Reporting.
Strong mathematical skills including calculating insurance benefits, deciphering EOBs and reviewing payment history on patient accounts.
Responsible for keeping the Advisor and Analyst informed of any enrollment irregularities or lack of provider follow-up with regards to total enrollment.
At least a high school diploma, GED, or equivalent education.
A medical billing and/or medical coding certificate or diploma.
MUST have prior experience in similar role.
Proficient in Microsoft Excel, Word, Outlook and OneNote.
Knowledge of Medicare, Medicaid, Commercial Insurance and Workers Compensation.
Ability to successfully resolve a minimum 400 patient accounts or 700 line items per month.
Intermediate ICD9 and CPT Code Knowledge.
Strong critical thinking skills including the ability to analyze AR and offer solutions for correction.
Ability to monitor and evaluate printing/scanning, mailing, & enrollment tasks on a daily basis.
Ability to successfully resolve a minimum 800 patient accounts items per month.
Requires excellent time management skills, the ability to communicate effectively across departments, and the ability to handle multiple projects at one time.