Reimbursement Specialist

Duties/Responsibilities:

• Verify patient coverage information and obtain authorization for services as needed


• Accurately document all actions taken to reconcile outstanding balances


• Evaluate the payment status of outstanding third-party claims and resolve any impediments to payment by providing information such as appropriate medical records, detailed itemization of charges, information regarding other insurance benefits, and explanation of charges.


• Review and validate adjustments to accounts in the insurance portfolio based on insurance reimbursement, coverage, contracts, and services provided.


• Review charges to ensure we are filing to correct guarantor (e.g. work comp vs. personal/family)


• Complete work on special projects, queries and reports as assigned

Required Skills/Abilities:

• Support co-workers and engage in positive interactions.


• Communicate professionally and timely with internal and external customers


• Demonstrate friendliness by smiling and making eye contact when greeting all customers.


• Provide helpful assistance in anticipating and responding to the needs of our customers.


• Collaborate with customers in planning and decision making to result in optimal solutions.


• Ability to stay calm under pressure and deal effectively with difficult people

Education & Experience:

• High school graduate or equivalent


• Associate’s degree in Business, Finance, Health Information Management, or related field is preferred.


• Two years of experience in a healthcare revenue cycle or clinic operations role.