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Reimbursement Specialist

2 months ago

Westchester, United States Midwest Orthopaedics at Rush Full time
It’s the people that make the difference. Are you ready to make your impact?

Midwest Orthopaedics at Rush is nationally recognized as a leader in comprehensive orthopedic services. The Orthopedic Program at Rush University Medical Center is ranked 5th in Orthopedics by U.S. News and World Report. Founded in 2003, MOR is comprised of internationally renowned Orthopedic and Spine surgeons who pioneer the latest advances in technology and surgical techniques to improve the lives and activity levels of patients around the world. MOR doctors are the official team physicians for the Chicago White Sox, Chicago Bulls, Chicago Fire Soccer Club and DePaul University Athletics.

Ready to join?We are looking for a Medicare/Medicaid Reimbursement Specialist at our Corporate office in Westchester, IL. This position will work specifically with Medicare collections, and direct Medicare experience is highly preferred.

Essential Duties and Responsibilities

  • Answer incoming calls into call center and assist patients/insurance companies with account questions in a courteous and timely manner. Ensure patient/insurance companies understand the billing statements and processes to provide the highest level of customer care.
  • Facilitate follow-up communications with insurance companies and patients regarding claim/payment status through practice management system and reporting tools.
  • Document all actions and maintain a permanent record of patient accounts to ensure a sufficient audit trail
  • Review and adjust balances according to fee schedules and management/MD requests, able to verify that claims have processed correctly by the insurance plan.
  • Research and obtain necessary documentation for insurance companies to process outstanding claims.
  • Identify denials and appeal with proper documentation within a timely manner to secure payment.
  • Answers patients' questions regarding statements and insurance coverage. Telephones or emails payers for follow up on outstanding claims.
  • Any other duties as assigned.
Education and/or Experience
  • High school diploma or general education degree (GED)
  • Minimum of 2 years Accounts Receivable/Collection experience in Medicare; preferably in an Orthopedic practice