Reimbursement Specialist

Creating Life Better Here Starts With You

At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.

The Reimbursement Specialist is entrusted to set a positive tone for every customer. They also demonstrate the ability to be a self-motivated, energetic person who can interact with third party payers in a courteous manner. The Reimbursement Specialist coordinates the customer's questions and serves as the communication for the CBO, in an attentive, courteous, and competent manner; serves as the liaison between patients and the insurance companies while demonstrating self-confidence, adaptability, and personal initiative; maintains a positive attitude and remains calm under pressure.

Required Behaviors:

• As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability, and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.

Required Qualifications:

• High School education or GED
• Knowledge of computer keyboarding
• Good communication skills
• Good telephone technique

Preferred Qualifications:

• Knowledge of 3rd party payers (i.e., Medicaid, Medicare, Commercial)
• Medical Terminology and coding experience

Duties and Responsibilities:

• Responsible for filing insurance claims for all third party payers in a timely and accurate manner
• Ensures goals and objectives established with CBO Manager are attained
• Mail appropriate forms to payers and/or patients
• Posting all payments received from insurance and patients, timely and efficiently
• Coordinating billing and limited follow-up activity associated with the collection of patient accounts
• Stays informed of changes in billing procedures that impact process and/or reimbursement effectiveness
• Professional appearance
• Commitment to successful operation of the clinic billing office
• Maintain strict patient confidentiality
• Documents relative information on patients accounts as per CBO protocol
• Each employee is responsible for implementing SJRMC’s Service Standards into their daily work: Safety, Courtesy, Effectiveness, and Stewardship
• Other duties as assigned

Physical Demands and Environmental Work Conditions:

• Lifting up to twenty-five (25) pounds is required
• Job is sedentary in nature and involves long periods of sitting
• Extensive computer keyboarding
• Posting involves communicating with clients/patients face to face, as well as on the phone