Reimbursement Specialist

Reimbursement Specialist

At Summit Orthopedics, we recognize the significance each member of the Summit Family has as they impact one another and our patients on a daily basis. Be part of a patient-first environment that lives into our values of: Compassion, Integrity, Excellence, Collaboration, Stewardship and Innovation and a place where staff members feel respected and find a strong sense of purpose in their roles, contributing to a familial atmosphere characterized by mutual respect and enjoyment. Under the direct supervision of the Reimbursement Manager, the Reimbursement Specialist will follow-up with the intent of collecting all delinquent unpaid insurance and patient account balances. This is a full-time position based at our Corporate Office located in Woodbury, MN. Monday - Friday schedule of 8:00 AM to 4:30 PM with the ability to work remotely once fully trained. (schedule subject to change). Primary duties:

• Work Systoc APM Work Queues on a daily basis in accordance with Business Office policies and procedures.
• Knowledgeable in payer orthopedic and PT policies and remain current with payer policies and protocols, sharing information within organization.
• Maintain account aging with emphasis on resolution of accounts more than 120 days from date of service.
• Identify, research and resolve any issues preventing payment of accounts.
• Communicate daily with insurance carriers, patients, medical office staff, and other third-party agencies to collect outstanding balances due, resolve disputes, denials, and general non-payment issues.
• Provide support and backup for Customer Service.
• Prevent timely filing denials by strict adherence to guidelines set by carriers for follow-up on initial claim filings and subsequent claim denials.
• Work all patient and insurance carrier refunds within established parameters.
• Act as backup to receipts area, posting payments to patient accounts, according to established policies.
• Review and approve accounts for collection agency placement.
• Perform due diligence in resolving outstanding balances ensuring all efforts have been exhausted in resolving issues with payers before writing off to bad debt, transferring to the next payer level or patient responsibility.
• Effectively maintain a high level of professionalism when contacting patients, insurance carriers, facilities and clinics and other third-party agencies while adhering to HIPAA regulations and patient privacy measures.

Summit's hiring range for this position is $20.64 to $25.80 per hour. The hired candidate may be eligible to receive additional compensation in the form of bonuses, differentials and/or deferred compensation. In addition to our base salary, we offer a comprehensive total rewards package that aligns with our vision of leading a healthy and active lifestyle. This includes medical, dental, vision, disability, life insurance, paid time off and 401(k)/profit sharing retirement plan. If you are hired at Summit, your final base salary compensation will be determined based on factors such as skills, education, experience, and internal equity. Summit Orthopedics provides the Twin Cities, Greater Minnesota and Western Wisconsin with the full spectrum of orthopedic care including sub-specialty clinics, walk-in care at our Orthopedic Urgent Care clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert team of physicians, surgeons, physician assistants, certified athletic trainers and therapists are part of the 1200+ employees who partner to provide quality care designed to support a healthier, more active lifestyle. Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

Education

Required: High School or better. Technical/other training or better in Business Administration or related field.

Experience

Required: 4 years: Minimum of 4 years of third party billing experience in a business office setting is required. Extensive knowledge of third party and government payer practices and requirements. Experience with medical software (PM, EMR, EHR).

Preferred: Previous insurance billing experience is preferred.