Reimbursement Representative

Responsibilities

USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization.

SUMMARY

The Reimbursement Representative performs reconciliation and review of all outstanding Medicare/Commercial patient balances in accordance with US Renal Care reimbursement policies and procedures.

Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned.

- Reviews EOB/EOMB's for proper reimbursement.

- Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner.

- Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment.

- Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed. Provides insurance carriers with requested information to facilitate payment.

- Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits.

- Performs claim appeals as required.

- Assists with credit balance resolution.

- Completes re-bill request as necessary to facilitate timely and proper claims payment.

- Follows up on unresolved account balances including RTP's.

- Prepares adjustment and write-off requests as necessary.

- Performs other duties and responsibilities as required or assigned.

Qualifications

Qualifications/Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

Requirements include:

- High School diploma or GED require

- At least two years of experience in a health/medical billing and collection office.

- Ability to use copier, fax machine, printer, calculator and multi-line telephone

- Must be proficient with computers with an understanding of medical billing software

- Advanced knowledge of medical terminology as well as knowledge of government and private insurer rules and regulations.

- Advanced knowledge of CPT, ICD-9 and HCPCS coding as well as in-depth knowledge of medical billing requirements

- Working knowledge of Microsoft Outlook, Word and Excel

- Ability to utilize the internet, specifically Medicare and Medicaid websites

- Maintain confidentiality in regard to HIPAA rules and regulations, as well as private company matters

Benefit Details

All Full-Time employees are eligible for the following benefits:
* Medical / Pharmacy
* Dental

- Vision
* Voluntary benefits
* 401k with employer match
* Virtual Care
* Life Insurance
* Voluntary Benefits
* PTO

All Part Time employees are eligible for the following benefits:
* 401k with employer match
* PTO

Pay Range

USD $22.00 - USD $24.00 /Hr.
Originally posted on Himalayas