Patient Financial Services Reimbursement Specialist I

Responsibilities

• Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up.
• Confirms electronic and hard-copy billing of any delinquent claims. Rebills and follow-ups of all delinquent claims.
• Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries.
• Advises other areas of updated insurance information and claim denials, i.e., registration.
• Follows through with education of rules and regulations in the managed care system, as well as State & Federal guidelines.
• Adjusts account balances to specific account needs.
• Maintains Contract Management reporting (i.e., payment errors, carve out billings) and updates any information as needed or requested by supervisor.
• Responsible for reviewing and resolving patient/insurance credit/debit balances and ensure proper communication is delivered to the patient.
• Adheres to all policies and procedures related to federal, state and department compliance for the position.

Qualifications

• High School Graduate or Equivalent required.
• Data entry and customer service experience preferred.
• Six months minimum experience in billing and collections is preferred.
• Medical Office/Healthcare experience preferred.