The Billing and Reimbursement Specialist will be assigned a group of dialysis facilities. In this role the Billing and Reimbursement Specialist will be responsible for the accurate and efficient billing and collecting of health insurance payments from insurance carriers. The Billing and Reimbursement specialists will coordinate, document, and communicate with health insurance representatives in regards to proper insurance payments in accordance with policies and procedures, and current federal, state and local standards, guidelines, and regulations.
Essential Functions and Responsibilities
- Responsible for accurate billing and collecting of revenue for all financial classes including Commercial, Federal and State insurance plans.
- Obtain and track claim status via phone and online portals.
- Compose and follow up on claims appeals
- Appropriately identify, address, submit or process adjustments, over-payments, and outstanding balances.
- Reviewing of Explanation of Benefits.
- Build relationships with insurance carriers and representatives.
- Allocating coinsurance and deductible appropriately within the database.
- Responsible for reviewing and addressing incoming mail correspondence.
- Communicating with patients regarding insurance checks.
- Communicate and collaborate with the internal departments.
- Maintains strict confidentiality of patient personal information.
- Maintains HIPPA compliance.
- Understands business implications of decisions.
- Performs other duties as requested by manager.
Experience and Skills
- Bachelor’s Degree preferred.
- 1 to 3 years of medical billing and collecting from Health Insurance carriers, or equivalent applicable work experience is preferred.
- Working knowledge of basic A/R principles, familiarity in working with health insurance plans, Medicare, Medicaid and Explanations of Benefits (EOB’s)
- Proficient with Microsoft Office, aptitude for learning additional software applications.
- Excellent verbal and written communication skills
- Customer focused, continually displaying integrity, courtesy, and compassion.
- Strong organizational and time management abilities, attention to detail, proven problem solving skills.
- Ethical conduct, personal effectiveness/credibility, thoroughness.
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American Renal Associates offers competitive pay and great benefits which include: health insurance, company-paid life, company-paid disability, 401(k), tuition reimbursement, a generous paid time off program and company-sponsored celebrations. We are an Equal Opportunity Employer and value diversity in our workplace. DFWP/ EOE. All inquiries will be held in strict confidence.