Reimbursement Specialist

Job description

Description Summary: The Revenue Reimbursement Specialist works to ensure that we are optimizing insurance collections, reducing outstanding balances, and maintaining the accounts receivables. Revenue Reimbursement Specialists will maximize reimbursement for all services while minimizing the amount of time it takes to obtain reimbursement; decrease AR sustain a low DSO. Responsibilities: - Communicate directly with the payor, resubmits denied claims, underpaid claims and claims that are inaccurately processed by auditing accounts to check on proper payments, coding, balances, adjustments, etc. using appropriate reports and queues - Review and analyze claim denials in order to perform the appropriate appeals necessary for reimbursement - Manage outstanding accounts receivable for assigned payers/Divisions. Resolve outstanding balances. - Follow up on outstanding accounts receivables, 31-60 days, 61-90 days. Includes researching aged account reports, outstanding “list”, processing problematic EOB’s and/or incoming mail or correspondence as identified. Special projects on 90+ days detailing problematic accounts and reporting them to the supervisor. - Identify errors, correct and commu...