We are seeking an experienced Reimbursement Specialist for an onsite position located in Kalamazoo, MI.
Job Overview:
Performs duties necessary to facilitate payment from third party payers. This includes correct billing, status-ing and collection from third parties, posting third party payments (if applicable), computing correct reimbursement, processing incoming and outgoing correspondence, and maintaining a working knowledge of current contracts and government regulations for multiple entities.
Daily Responsibilities:
Resolves billing issues up front to promote better reimbursement, reduce outstanding revenue and time spent on working rejections or additional claim follow up.
Prepares documentation to maximize reimbursement.
Analyze assignment of all CPT-4, ICD-10, UB04, HCFA 1500 and charges for accuracy and to maximize reimbursement from third party payers
Critically analyze and process third party and internal information requests and rejections in an effort to resolve accounts receivable.
Critically analyze and process documents for resolution of third party liabilities, outstanding credits and un-billed accounts.
Make all necessary posting, adjustments and refunds to accounts and critique contractual allowances and other arrangements.
Responsible for complete understanding and application of current contracts and governmental regulations including referrals for legal intervention for multiple entities.
Verifies insurance eligibility using automated on-line systems.