Reimbursement Specialist
4 weeks ago
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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