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Reimbursement Specialist

Coraopolis, PA

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Description

1. Contact (outbound phone calls) physician’s offices to check the status of outstanding forms on a designated schedule.
2. Contact patients (outbound phone calls) to discuss Assignment of Benefits or Proof of Delivery requirements and to follow up on unsigned documents.
3. Create documents required based on payer guidelines and submit them to the designated physician.
4. Closely monitor the timely filing guidelines of all payers to ensure that outstanding claims are billed within the payers timely filing period.
5. Receive inbound call volume that can include patient questions, physician information updates, patient complaints, etc.
6. Identify incorrect patient information and work with the physician and patient to bring the problem to a resolution.
7. Resend forms as needed to physicians for signature.
8. Communicate any ongoing documentation issues related to a physician or referral to the applicable sales representative.
9. Closely monitor and update the billing system – including the Patient, Doctor, Referral, Supporting Documentation and Billing Files.
10. Validate and Log returned CMNs, AOBs, and PODs in the billing system – contacting the physician’s office or patient to discuss any discrepancies.
11. Communicate any issues encountered during the documentation retrieval process to the Team Lead and/or Department Manager

Job Requirements

  • High School diploma required.
  • Highly assertive, independent decision-maker with excellent communication skills.
  • Detail and results oriented with superior organizational skills.
  • Must have the ability to prioritize.
  • Excellent time management skills.
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