Reimbursement Coordinator

Role Description

The Reimbursement Coordinator is responsible for following the reimbursement process to ensure timely and accurate payment for products and services provided to patients on behalf of WellSky clients. The scope of this job includes overseeing claims processing, payment posting and follow-up activities, along with addressing discrepancies and resolving claims denials.

• Obtain billing information from clients to generate claims, perform QA of charges, and make modifications or changes as required to produce a clean claim.
• Submit claims to insurance companies within the individual insurance company's timely filing period, prepare and/or print all secondary claims that do not automatically cross over from Medicare or other primary payer, and track pending claims.
• Utilize reports to determine tasks that require follow up and obtain claim's status by calling the payer and/or using an online claims status system.
• Research claim payments, partial payments and over-payments, and take appropriate action for escalating claims not paid within 60 days or for denied appeals.
• Perform collection follow up actions on primary and secondary claims as well as patient balances as assigned.
• Prepare write-off forms when bad debt is identified and document description of the reason for each write-off.
• Perform other job duties as assigned.

Qualifications

• GED or High School Diploma
• At least 1-2 years of relevant work experience
• Home Health billing/reimbursement experience
• Experience in EPIC EMR

Requirements

• Willing to work additional or irregular hours as needed
• Must work in accordance with applicable security policies and procedures to safeguard company and client information
• Must be able to sit and view a computer screen for extended periods of time

Benefits

• Excellent medical with Rx, dental, and vision benefits
• Mental Health support through EAP
• Generous paid time off, plus 13 paid holidays
• 100% vested 401(K) retirement plans
• Educational assistance up to $2500 per year