Reimbursement Specialist

Position Summary

This position helps Reimbursement Concepts meet contractual obligations and goals by ensuring the timely and accurate electronic transmission of medical claims through clearing houses and the submission of medical claims directly to insurance providers. It also ensures the timely and accurate resolution of outstanding invoices.

Essential Job Functions

Duties include, but are not necessarily limited to, the following:

• Responsible for timely and accurate electronic transmission of medical claims through clearing houses.
• Responsible for creating and submitting secondary medical claims in a timely manner.
• Responsible for daily editing of delivery tickets for HME, DME, and medical supplies.
• Responsible for payer or electronic transmission rejections.
• Researches claims denials and completes adjustments accurately and timely.
• Verifies that payments received are correct.
• Follows up on collections and appeals in an efficient and timely manner.
• Efficiently utilizes all functions of the company’s software applications, including maintaining accurate and detailed charts and notes.
• Clearly, accurately and concisely document notes in medical software system per company guidelines.
• Effectively identify and communicate to supervisor when assistance is needed (including, but not limited to, system function and training).
• Observes legal and ethical guidelines of HIPPA for safeguarding patient and company confidential and proprietary information.
• Consistently provides exceptional customer service for, and effectively communicates with, clients, patients, and payers.
• Exhibits a positive, courteous, respectful and helpful attitude to clients, co-workers, and management team.
• Understands and achieves team and individual goals as determined by supervisors.
• Promotes company culture by adhering to all policies and procedures.
• Welcomes constructive feedback and makes every effort to improve when required to help meet company goals.
• Adapts to and demonstrates the ability to accept frequent changes in the work environment based on customers’ requirements.

Additional Job Functions

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice based on business and/or client needs and requirements.

Knowledge, Skills and Abilities

• Working knowledge of medical billing, medical claims processing and accounts receivable collections.
• In depth knowledge of the Home Health Care industry.
• Ability to learn and understand medical billing protocol and reimbursement issues.
• Demonstrated ability to apply excellent verbal and written communication skills.
• Demonstrated ability to apply exceptional customer service skills both internally and externally.
• Applied knowledge of problem-solving skills and the ability to find and implement solutions to correct a situation.
• Demonstrated ability to prioritize, multitask, organize and utilize time efficiently.
• Ability to learn about and promote the services offered by our company.
• Demonstrates initiative to learn and apply newly acquired skills.
• Ability to perform duties with minimal supervision and remain on task until completion.
• Ability and desire to work as a contributing team member.

Minimum Requirements

• High School Diploma or GED required.
• Two years’ experience in DME/Home Health medical billing field.
• Knowledge of HCPC coding.
• A working background in medical billing terminology.
• Bilingual English/Spanish plus but not required.
• Applicants must pass background, credit and drug screens.

Job Type: Full-time

Salary: $13.00 to $16.00 /hour