Patient Financial Services Reimbursement Specialist I

About This Role

Coordinates and monitors all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable. This role is responsible for claims submission, payment application, denial management, and account follow-up to ensure optimal reimbursement.

Responsibilities

• Accurately processes claims, payments, rejections, refunds, credit balances, and unapplied cash on a daily basis and performs timely follow-up.
• Confirms electronic and hard-copy billing of any delinquent claims.
• Responds to all patient and payer inquiries, denials, correspondence, and telephone inquiries.
• Advises other areas of updated insurance information and claim denials, such as registration.
• Follows through with education of rules and regulations in the managed care system, as well as State & Federal guidelines.
• Adjusts account balances to specific account needs.
• Maintains Contract Management reporting (i.e., payment errors, carve out billings) and updates information as needed.
• Reviews and resolves patient/insurance credit/debit balances and ensures proper communication is delivered to the patient.
• Adheres to all policies and procedures related to federal, state, and department compliance for the position.

Requirements

• High School Diploma or equivalent
• Data entry skills
• Customer service experience

Qualifications

• High School Diploma or equivalent is required
• Minimum six months experience, desired experience in billing and collections or Medical Office/Healthcare.

Nice to Have

• Experience in billing and collections
• Medical Office/Healthcare experience