Reimbursement Specialist

  • Location
    Pittsburgh, Pennsylvania
  • Job type
  • Category
    Medical & Science - Billing / Collections

Reimbursement Specialist
Pittsburgh, PA
2+ months

Qualified candidates will possess a high school degree or equivalent; 2-3 years of additional schooling or related experience preferred and a minimum of 1 year A/R Follow Up experience required. Excellent verbal and written communication skills with strong attention to detail are required.

- System knowledge
- In depth knowledge of various insurance policies and procedures related to claim adjudication and payment processes.
- Ability to work independently with minimal supervision
- Excellent written and oral communication skills
- Strong attention to detail
- Represents the office/Organization in a positive manner; supports and encourages strong morale and spirit in his/her team.
- Can marshal resources to complete tasks and orchestrate multiple activities at once to accomplish goals
- Ability to solve difficult problems in a timely manner with efficient resolutions
- Works well with others; ability to work with and communicate with individuals of varying disciplines.
- Moderate to high level knowledge of Excel and Word
- Employee is regularly required to sit, use hands to finger, handle, or feel objects, tools, or controls and talk or hear. Employee must occasionally lift and/or move up to 25 pounds

Essential Functions:

Responsibilities include but are not limited to:

- Research and re-bill unpaid claims
- Research and resolve accounts appearing on Follow-up Reports.
- Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked.
- Correct all errors on electronic error reports using all available information.
- Meet production and quality standards.
- Participate in meetings with Payers, internal departments, Client contact(s) and BPS Management, etc. to address trends in denials or unprocessed claims
- Assists in identifying current and/or potential billing issues specific to outstanding receivable
- Presenting data to appropriate parties and partnering to develop resolutions
- Participates in daily production assignments that will continue to develop understanding and knowledge of processing guidelines and expectations of respective client(s) payer mix
- Ability to take patient phone calls and assist Customer Service when business needs arise
- Assist in other duties as assigned

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Reference number US_EN_2_022862_402742