Offer summary

Qualifications:

Bachelor's degree in business or healthcare management, 5+ years of experience in collections and claims follow-up, Strong background in claim resolution and denial management, Proficiency in Microsoft Office Suite, including Excel, PivotTable, and VLOOKUP..

Key responsibilities:

Perform accounts receivable follow-up on denied, unpaid, and underpaid claims

Coordinate and communicate with health insurance representatives regarding payments

Review and process claims appeals and adjustments

Build effective relationships with insurance carriers to resolve claims.

Job description

Title: Temp - Administrative - Reimbursement Specialist (Days) Beverly, MA

Description: Ideal candidate - Performed Accounts Receivable (AR) follow-up on denied, unpaid, and underpaid claims , rejections, collections, Explanation of Benefits (EOB), claim edits, and secondary billing.

THIS IS A FULLY REMOTE POSITION!

The Billing & Reimbursement Specialist I is assigned a group of dialysis facilities and is responsible for the accurate and efficient billing and collecting of health insurance payments from insurance carriers. The Billing & Reimbursement Specialist coordinates, documents, and communicates with health insurance representatives regarding proper insurance payments in accordance with policies and procedures and current federal, state, and local standards, guidelines, and regulations.

Essential Functions

Responsible for accurate billing and collecting of revenue for respective financial classes
Demonstrates a higher knowledge of respective financial class
Obtains and tracks claim status via phone and online portals
Composes and follows up on claims appeals
Appropriately identifies, addresses, submits and processes adjustments
Reviews and understands Explanation of Benefits documents
Builds effective working relationships with insurance carriers and representatives
Allocates coinsurance and deductibles timely and appropriately within applicable database
Effectively collects and/or resolves a higher volume of claims and more difficult accounts
Actively applies a solid foundation and knowledge of Billing and Reimbursement practices while exercising appropriate independent thought and decision-making skills to effectively troubleshoot and offer guidance on next steps

Submission Requirements

5+ years experience with collections and claims follow up - REQUIRED
Experience with full revenue cycle, specifically Medicare and Veterans Affairs reimbursements - REQUIRED
Must have a strong background in claim resolution (claims follow up/denial management) - REQUIRED
Must understand how to identify high priority areas of claims aging and be self-motivated/independent - REQUIRED
Bachelor's degree with a focus in business or healthcare management - REQUIRED
Knowledge of Excel, PivotTable and VLOOKUP - REQUIRED
Proficiency in Microsoft Office Suite - REQUIRED
Dialysis or healthcare experience - REQUIRED
Must be Bilingual - REQUIRED