Job description

Under the supervision of the PFS Director, the Reimbursement Specialist position is the lead responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices.

EDUCATION, EXPERIENCE, TRAINING

• Minimum four years hospital billing and collection experience required.
• Medical and Insurance terminology essential
• Knowledge of CPT, ICD-9, HCPCS coding structures
• Experience with payment/EOB review
• Experience with handling insurance denials
• Bachelor’s degree preferred

Job Type: Full-time

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Employee assistance program
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• Bachelor's (Preferred)

Experience:

• ICD-10: 4 years (Required)
• CPT coding: 4 years (Required)
• HCPCS: 4 years (Required)
• Insurance Denials: 4 years (Required)
• payment and EOB Review: 4 years (Required)
• Medical terminology: 4 years (Required)

Work Location: In person

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