Patient Financial Services Reimbursement Specialist II

Description

Summary :

The Patient Financial Services Reimbursement Specialist II plays a vital role in managing the complete lifecycle of patient financial accounts�from initial creation through final resolution. This position ensures seamless claims processing, accurate payment application, and effective denial management while maintaining compliance with billing regulations. With a strong focus on optimizing reimbursement, the specialist proactively monitors accounts, facilitates timely follow-up, and collaborates with internal and external stakeholders to resolve outstanding balances. Their expertise supports the organization�s financial integrity and enhances the overall patient experience by ensuring a smooth and efficient reimbursement process.

Responsibilities :

1. Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up. 2. Responsible for daily completion and correction of information for claims edit lists and rejections. 3. Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries. 4. Provides immediate access to explanation of benefits (EOB's), reports and other information as requested. 5. Offers guidance and training and provides performance input to Level I staff member's if requested. 6. Supports the Team Leader in monitoring the accuracy and completion of the cash application process. 7. Identifies departmental problems associated with procedures, system functionality, staff training and education, and reimbursement issues. Makes recommendations to management for improvement and resolution. 8. Performs trend analysis for management in order to determine registration & documentation deficiencies throughout the organization. 9. Adheres to all policies and procedures related to federal, state and department compliance for the position. 10. Maintains and Model the Organization�s values. 11. Demonstrates regular, reliable and predictable attendance. 12. Performs other duties as required.

Other Information :

Required : Data entry and MS Excel. Customer service experience required. Minimum Experience : one year Desired : Medical terminology, billing, cash applications and collection experience.

Working Conditions :

Manual : significant manual skills / motor coord & finger dexterity

Occupational : Little or no potential for occupational risk

Physical Effort : Sedentary / light effort. May exert up to 10 lbs. force

Physical Environment : Generally pleasant working conditions

Company : Nuvance Health

Org Unit : 1826

Department : Patient Accounting Med Practic

Exempt : No

Salary Range : $21.49 - $41.73 Hourly