Telecommute Healthcare Reimbursement Specialist

2 weeks ago


New Providence NJ, United States PRISM Vision Group Full time

The Revenue Cycle Specialist is responsible for billing and collecting payments. This position ensures that all accounts are billed appropriately and meets all regulatory and compliance requirements.
Respond to inquiries from insurance carriers, via telephone, email or fax and demonstrate a high level of customer service.
Pursue reimbursement from carriers by placing phone calls and documenting all communication in Athenahealth to ensure progress is made on outstanding accounts.
Identify and respond to patterns of denials or trends and perform complex account investigation as needed to achieve resolution.
Review and resolve uncollected accounts and prepare charge corrections.
Appeal carrier denials through review of coding, contracts, and medical records.
Research and appeal denied claims
Complete required reports and assist with special projects as assigned.
High School Diploma or General Education Degree (GED) with 3 years prior hands-on experience in a fast-paced medical billing environment. Strong communication, including writing, speaking and active listening
Effective computer skills with practice management software
Understanding of industry-specific policies, such as HIPAA regulations for health care
Effective communication abilities for phone contacts with insurance payers to resolve issues
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members
Knowledge of medical terminology
Knowledge of CPT/ICD-10 and modifier coding



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