Medical Reimbursement Specialist

Temporaries of New England , Inc.
East Hartford
Oct 05, 2016
Oct 19, 2016
Employer Type
Direct Employer
Employment Type
Full Time
Job Description:

Job Title: Medical Reimbursement Specialist Department: Administration: Billing Reports to: Billing Manager Classification: Non-Exempt Job Summary: Performs various revenue cycle tasks at the direction of the Billing Manager or Practice Administrator including but not limited to entering charges into the practice management system, following up with payers on outstanding balances, posting payments to accounts, submitting secondary and tertiary claims, answering patient billing questions and working task queues to maximize the receipt of appropriate revenue for the services provided. Responsibilities: Prepares and enters daily charges into the practice management system. Reviews and corrects denied claims for assigned payers on a daily basis including any required contact with payer or patient and other staff members to verify/obtain insurance information, coding and demographic information. Follows up with payers to ensure payment of outstanding claims. Coordinates and prepares explanation of benefits for submission to secondary and tertiary payers for payment. Prepares and submits appeals on denied claims. Performs follow-up on aging accounts through the use of a current aging or other receivables report(s). Answers the telephone, works with patients, insurance companies and other third party payers to resolve billing issues. Maintains clearly marked and dated tickler files of outstanding work. Performs download and upload process from payers when payments are electronic. Scans Explanations of Benefits (EOBs) into the practice management system. Performs other functions within the billing department related to patient statements, transmission of claims, report generation, etc. Medical Reimbursement Specialist Page 2 of 3 Works on departmental projects as assigned by supervisor. Complies with all HIPAA regulations. Other duties as assigned. Job Qualifications: Knowledge of medical terminology. Knowledge of spelling, English grammar and punctuation for written communications. Knowledge of the medical insurance industry and processes. Skill in operating typical office equipment including telephones, computers and multifunction machines. Knowledge of word processing and spreadsheet programs. Ability to read, understand and follow oral and written instructions. Ability to sort and file materials correctly by alphabetic or numeric systems. Ability to maintain pleasant and helpful manner in busy environment. Ability to establish and maintain effective working relationships. Thorough attention to detail. Ability to maintain confidentiality of sensitive information. Education: Associates degree or graduation from a technical school of medical billing or equivalent. Experience: Minimum one year experience in medical billing. Excellent knowledge of medical insurance and the medical billing process. Certificate/License: CPC preferred. Physical Demands: Position requires sitting for long periods of time with some stooping, bending or stretching for files or supplies. Occasional lifting of files or paper weighing up to thirty (30) pounds. Requires manual dexterity sufficient to operate a keyboard, type 60 wpm, operate a calculator, telephone, multifunction machine and other office equipment. Requires the ability to distinguish letters or symbols. Vision must be corrected to 20/20. Hearing must be in the normal range for telephone contacts. It is necessary to work and type at a computer workstation for long periods of time and to work in a fast-paced and stressful environment. Working Conditions: Work is performed in an office environment with multiple individuals occupying desks grouped in an open space. Telephone, desk and computer work is required. Work may be stressful at times. Regular contact with other staff members, patients, insurance company representatives and physicians. Contact may involve dealing with upset, angry or confused individuals.