Medical Reimbursement Specialist

Job Title *THIS IS NOT A VIRTUAL POSITION, YOU MUST LIVE WITHIN OR BE WILLING TO RELOCATE WITHIN A COMMUTABLE DISTANCE OF THE DUTY LOCATION* These positions involve a multi-grade career ladder. The major duties listed below represent the full performance level of GS-6. At the GS-5 grade level, you will perform assignments of a more limited scope and with less independence. You will progressively acquire the background necessary to perform at the full performance level of GS-6. Promotion is at the discretion of the supervisor and is contingent upon satisfactory performance, availability of higher level work, and availability of funds. Major duties include but are not limited to: Performs verification of patient insurance coverage; Obtains patient insurance information through automated databases, direct patient contacts and contact with insurance companies; Verifies benefits, policy number, pre-certification requirements and effective dates of coverage; Accepts and completes work provided by a standardized control system such as batched work, caseload level or other defined structure; Responsible for Medicare and Commercial insurance reimbursable billing activities; Ensures that all billable cases are identified and that bills are accurately generated; Validates clams for billing purposes ensuring eligibility and referring questionable coding for review; Follows instructions about timeliness, objectives and relative priorities for doing work; Exercises sound judgment to determine the appropriateness of data and information provided on a claim; Effectively communicates with other staff as necessary to discuss billing and insurance discrepancies; Uses a wide range of office software applications; Performs other duties as assigned. Work Schedule: Monday through Friday, 8:00am to 4:30pm Recruitment & Relocation Incentives: Not authorized Critical Skills Incentive (CSI): Not Approved