Patient Financial Services Reimbursement Specialist I

About the Organization

Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses, and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut, and beyond. Northwell is New York State’s largest private employer with over 104,000 employees.

About the Role

Coordinates and monitors all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable functions. Responsible for the assigned area’s claims submission, payment application, denial management, and account follow-up to ensure optimal reimbursement.

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 follows up on 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 (e.g., 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 (e.g., payment errors, carve-out billings) and updates any information as needed or requested by supervisor.
• Reviews and resolves patient/insurance credit/debit balances and ensures proper communication is delivered to the patient.
• Adheres to all policies and procedures related to federal, state, and department compliance for the position.
• Maintains and models the organization’s values.
• Demonstrates regular, reliable, and predictable attendance.
• Performs other duties as required.

Requirements

• 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.

Working Conditions

• Manual: Significant manual skills, motor coordination, and finger dexterity.
• Occupational: Little or no potential for occupational risk.
• Physical Effort: Sedentary/light effort. May exert up to 10 lbs. of force.

Pay

$19.54 - $29.00 hourly