CBO Reimbursement Specialist

Job Title

Accurately evaluates each account in order to determine what is needed, what is left outstanding and what steps are necessary to resolve the account quickly

Communicates effectively with assigned payer, other departments and leadership to identify trends, help find solutions and implement changes that will positively effect reimbursement

Coordinates Software in order to Run Reports and provide accurate feedback regarding Denials and Underpayments to Leadership

Understands payer contracts and how to analyze them in order to preview an account to determine if properly paid and identify when errors are made in payments

Accurately identifies and evaluates denials and underpayments in order to determine reason and investigates the issue to determine the best course of action to have payer pay at the maximum reimbursement allowed per our contract

Able to format an effective appeal letter where appropriate verbiage is used to reference the contract violation any applicable references and is clear to the reader as to what is expected

Minimum Qualifications

High school graduate or GED certificate.

Minimum 5 years medical collection experience.

ICD-10 and CPT coding knowledge a must; Basic computer skills; Adequate keyboarding skills (40 words per minute typing rate).

Ability to read, write and speak intelligible English; Ability to communicate with patients, family, peers and medical personnel.

Requires emotional stability and resilience; Exhibits organizational and leadership ability; Able to understand and relate to specific ideas generally, several at a time, and remember multiple tasks given to self and others over long periods of time.