Lead Reimbursement Specialist

>> We offer our team the best <<

• Medical, Dental and Vision Benefits
• Continued Education
• PTO Plan
• Retirement Planning
• Life Insurance
• Employee discounts

Position Summary: This position is responsible for overseeing production for all billing and revenue cycle management thorough insurance benefits investigation of new referrals, collections, authorization requests, and claim submission. The position provides day to day guidance on routine issues to ensure that the daily work of the team is completed accurately and on time.

Schedule: Mon-Fri / Full-time

Essential Duties:

• Follows up on underpaid accounts, as needed
• Reviews EOB/EOMB’s to determine why reimbursement was not paid in full
• Provides insurance carriers with requested information to facilitate payment
• Prepares appeals and adjustment requests as necessary
• Monitor employees’ daily performance and productivity
• Keeps team informed of new processes and general updates
• Demonstrates ability to identify and recognize issues and provide unique, exception-based, workable resolutions for Manager to review
• Provides analysis to Manager on trends being seen with payers
• Provides analysis to Manager as it relates to fee schedules/system profile issues
• Uses motivational techniques to assist team members in maintaining and exceeding standard
• Demonstrates accelerated knowledge of system(s) functions as it effects daily work flow and team/department processes
• Assists Manager in development of staff
• Works collaboratively to problem solve and participate cross functionally with other teams as necessary
• Conducts audits on work and determines additional training that may be required due to the results of the audit; including, providing recommendations, guidance, and implementing solutions to improve results
• Acts as first point of contact on technical and procedural questions
• Assists with the creation and documentation of processes. Makes recommendations, as appropriate, on process improvements
• Maintains a high degree of confidentiality at all times due to access to sensitive informatio
• Maintains regular, predictable, consistent attendance and is flexible to meet the needs of the department
• Follows all Medicare, Medicaid, and HIPAA regulations and requirements
• Abides by all regulations, policies, procedures and standards
• Performs other duties as assigned

Performance Responsibilities:

• Maintains positive internal and external customer service relationships
• Maintains open lines of communication
• Plans and organizes work effectively and ensures its completion
• Meets all productivity requirements
• Demonstrates team behavior and promotes a team-oriented environment
• Actively participates in Continuous Quality Improvement
• Represents the organization professionally at all times

Position Requirements & Competencies:

• High School diploma or GED required. College degree in Business or related field preferred
• 5 years plus relevant work experience in a health/medical billing office preferred
• Some supervisory or lead experience preferred
• Proficiency with personal computers including Microsoft Office; excellent written and verbal communication skills
• Advanced knowledge of medical insurance terminology, ability to handle a fast-paced environment
• Strong attention to detail, strong team building skills, research and analysis skills, report preparation and documentation skills; ability to train other team members

To apply via text, text 5267 to 334-518-4376

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