Reimbursement Specialist

Job Description

Job Description

POSITION SUMMARY :

Under the supervision of the Corporate Director of Insurance Contracts, the Reimbursement Specialist is responsible for assisting hospitals with maximizing collections and minimizing outstanding accounts receivable aging percentages by performing revenue cycle functions. The Reimbursement Specialist will monitor Denials and Payment Variance reports to identify accounts that could benefit from an appeal and escalation with the payor. The Reimbursement Specialist will communicate with carriers regarding underpaid or denied claims as well as well as filing of appeals to carriers. The Reimbursement Specialist should have a good understanding of the contracts, payer manuals, system build of the contracts, and be able to identify if the variance is a true underpayment or if it a system set up issue.

QUALIFICATIONS :

• High-school diploma or GED required. Associate degree in related field preferred.
• Two years recent experience in the healthcare industry, i.e. performing CDM-related tasks, Certified Professional Coder (CPC), or other revenue cycle functions.
• Excellent Microsoft Excel skills

NOTE : Candidate MUST reside in the state of Louisiana and be able to travel to the nearest CBO location for training and other necessary requirements.

Preferred Experience :

Physical Demands :

Sedentary Work : Exerting up to ten pounds of force occasionally or a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including ones self. Primarily involves sitting most of the time, but will require walking or standing for brief periods of time. Talking and hearing with the ability to communicate by means of language. Near acuity with clarity of vision at 20 inches or less required. Ability to read, record, or type data quickly and accurately required.