Reimbursement Specialist

4 weeks ago


Knoxville, United States StaffSource Full time
Job DescriptionJob Description

Responsibilities

•Audits all outstanding claims transactions to determine denial and take appropriate steps to correct the claim for reimbursement

•Obtains and verifies a client's insurance coverage and ensures procedures are covered by an individual's insurance

•Enter data accurately and update client information in billing system

•Perform a variety of auditing and resolution-centered activities, answering pertinent questions about coverage to internal and external sources, identifying insurance errors, and recommending solutions

QUALIFICATIONS:

• High School Diploma or Equivalent is required. Associate's or Bachelor's preferred.

Experience / Knowledge:

• Minimum 1 year of experience in medical insurance processing.

• Experience in behavioral/mental health billing, knowledge of CPT, and medical coding preferred.

 • Knowledge of insurance guidelines including HMO/PPO, Commercial, Medicare, Medicare Advantage, TennCare's, Medicaid and Private Pay.

• Advanced computer skills with an electronic medical record (EMR), e-mail, Microsoft Word, and Excel.



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