Our client is looking to add a ReimbursementSpecialist to their team. This is a strong, growing organization with room for advancement! The position is located at their corporate office in Plano.
RESPONSIBILITIES
Reviews EOB/EOMB's for proper reimbursement.
Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner.
Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment.
Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed. Provides insurance carriers with requested information to facilitate payment.
Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits.
Performs claim appeals as required.
Assists with credit balance resolution.
Completes re-bill request as necessary to facilitate timely and proper claims payment.
Follows up on unresolved account balances including RTP's.
Prepares adjustment and write-off requests as necessary.
Performs other duties and responsibilities as required or assigned.
Researching problems with out of network collections.
Requirements
Reimbursement Specialist
EDUCATION and EXPERIENCE:
High School diploma or GED required.
Minimun of two years of experience in health/medical collections.
Must have analytical skills.
Strong knowledge/experience using Microsoft Excel.
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