Accounts Receivable Specialist

2 days ago


Fremont, California, United States Info Way Solutions Full time
Job Summary

The Reimbursement Specialist is responsible for ensuring accurate and timely reimbursement of medical claims from insurance carriers, third-party agencies, and patients. This role requires strong communication and analytical skills to resolve claims-related issues and maintain compliance with federal, state, and local regulations.

Key Responsibilities
  • Collect and process medical claims related to Commercial, Federal, and State insurance plans and private pay accounts, ensuring timely follow-up and minimizing aged accounts receivables.
  • Obtain and track claim status via phone and online portals, and respond to denials and claims-related correspondence.
  • Compose and follow up on claims appeals within specified payer timelines and protocols, and identify and address overpayments and outstanding balances.
  • Review and respond to payment information associated with Explanation of Benefits or Remittance Advice documents, and build relationships with insurance carriers and representatives.
  • Update claims related to change of insurance, and maintain strict confidentiality of patient personal information and HIPAA compliance.
  • Collaborate with internal departments to ensure seamless communication and efficient claim processing.
Requirements
  • Bachelor's degree or equivalent work experience in a healthcare-related setting.
  • Four years of direct work experience related to medical claims billing/collections, insurance, appeals, and authorizations.
  • Durable Medical Equipment (DME) claim processing experience preferred.
  • Superior customer service skills, excellent verbal and written communication skills, and strong computer skills, including word processing and spreadsheet software.
Work Location

5905 Nathan Lane, Plymouth MN 55442

Note

This role will be hybrid - 2 days onsite and 3 days working from home.



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