[Hiring] Reimbursement Specialist @National Seating & Mobility

Role Description

The Reimbursement Specialist supports the Reimbursement team by identifying and correcting claims submission/payment errors. The Reimbursement Specialist is responsible for the accurate and timely follow-up of unpaid claims, by assigned payers and defined aging criteria to meet or exceed collection targets and minimize write-offs. This position ensures proper reimbursement was received according to payer contracts and fee schedules, correcting billing issues, and billing secondary claims.

Duties and Responsibilities / Essential Functions

• Performs timely and accurate follow-up on claims to payers and patients following prescribed policies and procedures.
• Responsible for preparing and submitting timely and accurate rebilled claims and initial billed secondary/tertiary claims to payers following prescribed policies and procedures.
• Enters certain demographic data into the billing and collections software following prescribed policies and procedures.
• Generates claims for both electronic and/or hard-copy submission.
• Generates Missing Information Requests (MIR) following prescribed policies and procedures.
• Identifies variances between booked revenue and expected reimbursement to facilitate accurate reimbursement of claims as defined by contracts, and state and federal law.
• Identifies and reports violations of NSM Credit Policy.
• Participates in collecting and documenting payer specific claims processing rules, practices and guidelines to contribute to, and maintain, the currency and accuracy of payer requirements for NSM personnel.
• Complies with and supports department and organizational policies and procedures.
• Assumes other duties and responsibilities as assigned.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee is regularly required to sit; use hands repetitively to operate standard office equipment. The employee is frequently required to reach with hands and arms.

Qualifications

• High School Diploma or equivalency certificate.
• Experience in working with billing and collections software highly desirable.
• Knowledge of medical billing and insurance claim filing, communications skills.
• Proficient in Microsoft Excel, Word, and Outlook. Adobe Acrobat is a plus.
• Strong data entry skills - keyboarding/accuracy/speed.
• Working knowledge of Microsoft suite of products (i.e. Outlook, Word and Excel) and Adobe Acrobat.