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Reimbursement Specialist

Grapevine, TX

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Description

 

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