Job Summary:
This role involves managing billing and collections for outstanding accounts from various payors (commercial government and managed care). The Reimbursement Specialist I will identify and report payor issues interpret complex contract language to calculate expected reimbursements and pursue outstanding payments. The position requires proficient use of internet resources professional communication (written and verbal) and Microsoft Office Suite.
Location: San Diego California United States
Responsibilities:
- Billing and collections of outstanding account balances.
- Identifying and reporting payor issues to leadership.
- Interpreting complex payor contract language to calculate expected reimbursements.
- Pursuing all payments due to the organization.
- Performing account collection activities using internet resources and professional telephone communication.
- Composing professional written correspondence with internal and external entities.
- Reviewing denials/underpayments and taking corrective actions based on denial rationale and reason codes.
Required Skills & Certifications:
- High School Diploma or GED equivalent.
- Two years of experience as a Healthcare Reimbursement Specialist.
- Proficiency in Microsoft Excel Word and Outlook.
Preferred Skills & Certifications:
- None specified in the provided text.
Special Considerations:
- Onsite position.
Scheduling:
- Not specified in the provided text.