Reimbursement Counselor

Artech Information Systems is the #1 Largest Women-Owned IT Staffing Company in the U.S. and an employer of choice for over 7,500 consultants. We recruit world-class talent for IT, engineering, and other professional jobs at 70+ Fortune and Global 500 companies coast-to-coast across the U.S., India, and China. We are one of the fastest-growing companies in the US.

At the forefront of the staffing industry, Artech is a minority and women-owned business enterprise (MWBE) committed to maximizing global workforce solutions on behalf of its clients. Artech's deep heritage, proven expertise and insightful market intelligence has secured long-term partnerships with Fortune 500 and government clients seeking world-class professional resources.

Job Description

Job Description :

• Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and / or refunds, until accounts receivable issues are properly resolved.
• Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program.
• Provides assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications.
• Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors. Researches and resolves any electronic claim denials.
• Researches and resolves any claim denials or underpayment of claims. Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods. Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly.
• Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers.
• Reports any reimbursement trends / delays to supervisor (e.g. billing denials, claim denials, pricing errors, payments, etc.).
• Processes any necessary insurance / patient correspondence.
• Provides all necessary documentation required to expedite payments. This includes demographic, authorization / referrals, National Provider Identification (NPI) number, and referring physicians.
• Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process.
• Maintains confidentiality in regards to patient account status and the financial affairs of clinic / corporation.
• Communicates effectively to payors and / or claims clearinghouse to ensure accurate and timely electronically filed claims.
• Works on problems of moderate scope where analysis of data requires a review of a variety of factors.
• Exercises judgment within defined standard operating procedures to determine appropriate action.
• Typically receives little instruction on day-to-day work, general instructions on new assignments. Performs related duties as assigned.
• Ability to communicate effectively both orally and in writing. Ability to build productive internal / external working relationships.
• Strong organizational skills; attention to detail.
• General knowledge of accounting principles, pharmacy operations, and medical claims.
• General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred.
• Global understanding of commercial and government payers preferred.
• Ability to proficiently use Microsoft Excel, Outlook and Word.
• Is developing professional expertise; applies company policies and procedures to resolve a variety of issues.

Qualifications

Additional Information

All your information will be kept confidential according to EEO guidelines.

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