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Reimbursement Specialist

Philadelphia, PA

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Job Description: The Reimbursement Specialist works with insurance and billing companies to determine the method of payment for patients. Working in this position requires a strong attention to detail and a high level of familiarity with clerical and office processes. Role and Responsibilities: • Prepares documentations and processes computer input of patient accounts to ensure timely follow-up. • Reviews diagnosis, procedure codes, and charges for accuracy and obtains from appropriate department when necessary. • Verifies patient eligibility using appropriate systems, and checks system for possible overlap claims. • Requests additional insurance information and assignments from patients. • Copies appropriate insurance information to submit with billing. • Updates insurance information and Financial Class. • Processes and submits claims to the appropriate intermediary to ensure accurate and prompt reimbursement of charges. • Sends all necessary information and documents to payer. • Processes complete and timely claim follow-up as required to ensure claims are adjudicated in shortest amount of time, 14 business days. • Responsible for electronic error/reject reports worked accurately each day. • Completes weekly explanation of Aged A/R. • Performs other duties as necessary to assist in the functioning of the department. • The requirements listed below are representative of the knowledge, skill, and/or ability required including computer skills/level. • Ability to work independently. • Ability to exercise judgment and make decisions. • Excellent communication skills to communicate with patients, physicians, clients, coworkers, and management staff. • Ability to perform in a high productivity, fast-paced environment. • Ability to document accurately and concisely. • Excellent phone and computer skills. • Ability to maintain sensitive information in confidence • Ability to meet deadlines and prioritize diverse responsibilities. • Proficient in Microsoft applica

Job Requirements

Medical billing and reimbursement experience needed

Claims and Adjudication experience

Prior experience with submitting medical claims, reviewing, understanding charges, CPT, ICD10 and various other codes.

MS Office experience


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