Reimbursement Specialist

Job TitleJob Purpose: Responsibilities include patient account follow up on all types of hospital claims. This includes following accounts through secondary and subsequent payers. Must have thorough knowledge of hospital managed care contracts, standard collection processes and state and federal regulations. An understanding of medical terminology and diagnosis and procedure coding is needed.Education & QualificationsHigh School diploma or equivalent required.Work ExperienceMinimum three years of experience as a hospital collector. Extensive knowledge of payer rules and regulations, including at least 2 years' experience with Texas Medicaid and government payers. Microsoft Office literacy is needed. Meditech experience a plus.Physical Demands & Working ConditionsThe physical demands described here are representative of those that must be met by an employee to successfully to perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is regularly required to use hands to finger, grasp, handle, or feel and to reach with hands and arms. The employee is frequently required to sit, stand, walk, see, speak, and hear. The employee is occasionally required to kneel, climb, or balance. The employee is regularly required to lift up to 10 pounds and rarely lift more than 25 pounds. There will be prolonged periods of sitting and data entry.Special RequirementsMust be able to communicate effectively and professionally by phone and in writing. Must have good math skills. Ability to receive, comprehend, and carry out instructions; ability to work safely with equipment, supplies, and materials; ability to comply with attendance requirements; ability to comply with Human Resource policies.Essential Job Responsibilities• Review all accounts with payments previous day. • Review and resolve reminder queue daily. • File secondary, tertiary, etc. paper claims as needed. • Maintains established policies and procedures, objectives, quality assurance programs and safety standards. • Participates in educational programs and in-services. • Provide customer service for patients, internal customers and insurance companies as needed. • Performs other duties as assignedCash Management Support* Posting electronic payments received daily. • Print bank statements and review payments received. • Print and file payment batches by date, batch number. * Performs other duties as assigned