Patient Financial Services Reimbursement Specialist I

Description

Summary :

Coordinates and monitors all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable functions. Responsible for the assigned area�s claims submission, payment application, denial management, and account follow-up to ensure optimal reimbursement.

Responsibilities :

1. Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up. 2. Confirms electronic and hard-copy billing of any delinquent claims. Rebills and follow-ups of all delinquent claims. 3. Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries. 4. Advises other areas of updated insurance information and claim denials, i.e., registration. 5. Follows through with education of rules and regulations in the managed care system, as well as State & Federal guidelines. 6. Adjusts account balances to specific account needs. 7. Maintains Contract Management reporting (i.e., payment errors, carve out billings) and updates any information as needed or requested by supervisor. 8. Responsible for reviewing and resolving patient / insurance credit / debit balances and ensure proper communication is delivered to the patient. 9. Adheres to all policies and procedures related to federal, state and department compliance for the position. 10. Maintains and Model the Organization�s values. 11. Demonstrates regular, reliable and predictable attendance. 12. Performs other duties as required.

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.

Working Conditions :

Manual : significant manual skills / motor coord & finger dexterity

Occupational : Little or no potential for occupational risk

Physical Effort : Sedentary / light effort. May exert up to 10 lbs. force

Physical Environment : Generally pleasant working conditions

Company : Nuvance Health

Org Unit : 1785

Department : Patient Accounting

Exempt : No

Salary Range : $21 - $25.00 Hourly