Patient Financial Services Reimbursement Specialist I
Patient Financial Services Reimbursement Specialist I
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Job Description
Description
Summary:
Maintains accurate and timely claim submission for designated groups of accounts by that all claims are compliant with State and Federal billing regulations and contractual cash from third party payers and inquires by mail or phone as related to the designated group of accurate and timely application of cash statements to insure an effective billing system.
Responsibilities:
1. Accurate timely and compliant claim submission. 2. Confirmation of electronic and hardcopy billing of any delinquent claims. Rebilling & followup of all delinquent claims. 3. Responds to all patient and payer inquiries denials correspondence & telephone inquires. 4. Maintains all reports (contract management) files and records as needed; i.e. medical records referrals precertification letters etc. 5. Advises other areas of updated insurance information and claim denials; i.e. registration. 6. Follows through with education of rules and regulations in the managed care system as well as State & Federal guidelines. 7. Adjusts account balances to specific account needs; i.e. capitated labs. 8. Maintains Contract Management reporting (i.e. payment errors carve out billings and updates any information as needed or requested by supervisor. 9. Applies cash received to appropriate accounts. Refunds all overpayments as necessary. 10. Maintains departmental policies and procedures. 11. Adheres to all policies and procedures related to compliance with all federal & state billing & collection regulations & third party contractual obligations. 12. Fulfills all compliance responsibilities related to the position. WCHN Position Description P
Other Information:
Required: Data entry. Customer service experience required. Minimum Experience: six months Desired: Experience in billing and collections or Medical Office/Healthcare experience preferred.
Company: Nuvance Health
Org Unit: 1785
Department: Patient Accounting
Exempt: No
Salary Range: $19 $33.48 Hourly
Required Experience:
Unclear Seniority
Employment Type
Full Time
