Insurance / Patient Reimbursement Specialist

Overview

The remote Insurance / Patient Reimbursement Specialist works in a team environment to interpret and evaluate patient and insurance credit balances in NextGen. This includes following up with payers and insurance providers to assure timely turn around for claims resolution and reimbursement and also reviewing accounts to ensure charges, payments and adjustments are entered correctly in the system before refunding. Accounts payable in a clinic setting is highly desired.

Responsibilities

ESSENTIAL FUNCTIONS

• Review of outstanding patient and insurance credits via a tasking work log, patient encounter notes / emails, Excel spreadsheet, and insurance refund request letters.
• Review of outstanding patient / insurance credits to verify that each charge, payment, and adjustment is entered correctly in the system before processing the refund.
• Utilize web portals to investigate and critique insurance claims as necessary
• Regular phone and email interaction with insurance companies, clinic staff, and patients to resolve claim credit issues
• Ability to problem solve and think critically
• Assist with major insurance and patient billing issues
• As part of an overflow queue, answer any incoming telephone calls
• Review and complete other practice management reports as necessary
• Operate in a team oriented work environment
• All other job related duties as assigned

Qualifications

EDUCATION

KNOWLEDGE, SKILLS AND ABILITIES

PHYSICAL DEMANDS

For this position, the base pay range is $17.50-$18.00 per hour. Individual pay is determined by role, level, location, job-related skills, experience, and relevant education, certifications or training.