Collections Reimbursement Specialist

Job Description

Job Description

PRIMARY RESPONSIBILITIES:

• Run and review aging accounts receivable reports
• Identify and report payer denial trends and resolve outstanding accounts receivable; shares payer trending data with internal departments to ensure a reduction in the number of denials
• Responsible for timely insurance denial, appeal and claim follow up activities to maximize collection efforts and reviews collection worklists
• Ensure timely follow up on all patient and insurance refund requests and credit balances
• Recommend and complete account adjustments, where appropriate
• Identifies insurance contract opportunities/requirements and communicates to the Payor Relations department
• Answer and respond to telephone, email, and faxed inquiries from internal and external customers, which include clients, patients, and insurance carriers, while providing excellent customer service
• Analyzes and determines accounts to transfer to External Agency for collection
• Accepts and negotiates payment arrangements and contacts patient(s) regarding missed payments
• Assist with obtaining prior authorizations
• Provide patient balance estimates and verify insurance for all payers, including Medicare, Medicaid, and commercial insurances
• Identifies underpayments and overpayments made by third-party payers while monitoring credit balance report
• Processes patient financial hardship applications and reviews requests for account adjustments
• Process, sort, and direct incoming and outgoing mail to the appropriate teams and departments
• Maintain patient accounts by appropriately notating, updating, and collecting patient demographic, and insurance information
• Request medical records and other patient information, when appropriate
• Provides management team with immediate feedback on issues affecting workflow, reimbursement, and customer service
• Attend staff meetings and report on monthly performance and activities
• Adheres to appropriate quality control, confidentiality, and HIPAA guidelines

QUALIFICATIONS, SKILLS & COMPETENCIES:

• Bachelor’s degree, preferred
• 5 + years of Medical Accounts Receivable, Medical Billing, Customer Service, Denial Management and Collections experience
• Previous experience with medical claims processing, insurance verification, medical records and insurance terminology
• Competency with Windows PC Applications, including strong Microsoft Word and Microsoft Excel skills
• Strong keyboard and navigation skills and ability to learn new computer skills & applications
• Proven ability to collect and resolve aging accounts receivable balances
• Equipped to handle multiple tasks, accurately process high volumes of work, prioritize work and manage time effectively to meet deadlines
• Capable of making decisions and solving problems using established departmental standard operating procedures and guidelines with limited supervision
• Demonstrated effective and appropriate communication styles and interpersonal skills that promote positive and professional working relationships with peers and management team
• Ability to assist with and adapt to departmental and / or company procedural changes
• Able to work a 40-hour schedule within the operating hours of the department, 8 AM to 9:30 AM start time and ending 5:00 PM to 6:30 PM
• As this is a hybrid position, must be able to commute to headquarters in Mount Laurel, NJ
• It may be necessary, based on business and departmental need, to work occasional overtime and/or weekends.
• Telecommute work possible, subject to business environmental conditions

BENEFITS:

• Competitive salary and bonus structure
• Health, dental and vision insurance as well as other ancillary benefits
• Retirement savings plan – 401(k) – with company match
• Paid time off (PTO) and holidays
• Professional development and training opportunities
• Employee wellness programs

EEO STATEMENT:

RMX Monitoring, LLC. is an equal opportunity employer who openly supports and fully commits to recruitment, selection, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state, and/or local laws. Inclusion and diversity amongst our teams is essential to our success.