Reimbursement specialist

Main Responsibilities:

• Review, correct, and process claims for all payers, both electronically and manually
• Investigate and resolve claim denials, making corrections as needed

• Apply accurate contractual adjustments to resolve outstanding balances
• Respond to billing inquiries from patients and insurance representatives professionally and promptly
• Reconcile patient collections and deposits
• Identify and report denial trends; propose solutions to reduce future denials
• Process refund requests and ensure compliance with payer guidelines
• Maintain accurate and detailed documentation within patient account
• Process appeals, including online and paper submissions
• Submit outstanding accounts receivable daily per company protocol
• Work claims exceptions (ERL rejections) through the clearinghouse each day
• Interpret Accounts Receivable and apply correct adjustments in accordance with accounting principles
• Review and resolve aged held billing issues (e.g., sales orders not auto-confirming due to errors)
• Collaborate effectively across departments to gather and share necessary data.

Profesional

Bachillerato edu. diversificada

Educación Secundaria

2 años de experiencia

1 Vacante