Reimbursement Specialist

4 days ago

Marcus Hook, Pennsylvania, United States Quality Talent Group Full time
About the Job

The Reimbursement Specialist - Cash Applications role is a critical position within our organization, responsible for ensuring timely, accurate, and compliant cash/denial/adjustment transactions.

Key Responsibilities
  • Cash Posting: Accurately post cash receipts, denials, and adjustments from 3rd party remittances and Explanations of Benefits (EOB) to the appropriate patient invoices.
  • Organize and prepare lockbox deposits for cash posting and distribution to the appropriate team on a daily basis.
  • Determine if credit balances are duplicate or overpayments that must be adjusted and/or transferred to a liability account and subsequently refunded to the payer or patient.
  • Contact insurance payers for missing remittances when necessary.
  • Utilize all available reports to reconcile cash receipts posted to cash reported on deposit by the banking institution on a daily basis and/or per batch, as outlined and established by policy.
  • Generate and review reporting to ensure transactions are properly posted, correcting any errors or misstatements as needed.
  • Use discretion and experience to identify and communicate any discrepancies to the attention of the Supervisor.
  • Post insurance carrier take-back/recoupment and track subsequent utilization based on review of reimbursements EOB and comparison against known outstanding liabilities.
  • Accurately and concisely document accounts so that information can be readily understood by others throughout the company.
Projects and Audits

The Reimbursement Specialist - Cash Applications will be involved in a variety of projects and audits as outlined by leadership, including but not limited to:

  • Pricing analysis
  • Payer audits
  • Assessment of credit balances for refund or revenue adjustment
  • Payment analysis of HCPCS coding for non-contracted payers
  • Cash trends
  • DSO reporting
Ideal Candidate

We are seeking an individual with a strong background in billing, collections, or cash posting, preferably with experience in a physician office, specialty infusion, home care, or related field.

The ideal candidate will possess:

  • Associates degree, some college coursework, and/or a combination of education and experience.
  • Minimum of 2 years hands-on experience in a billing, collections, or cash posting role.
  • Proficiency in CPR+ or similar platform.
  • Experience with MS Office, especially Word, Excel, and PowerPoint.
  • Demonstrated ability to review remittance from a variety of payers, investigate issues with invoices, and confer with internal and external parties to resolve discrepancies.
  • Ability to calculate figures and amounts correctly, such as interest and percentages, and reconcile cash posted to cash received.
  • Clear and effective communication of the American English language via face-to-face, telephone, and written communication.
Troubleshooting and Problem-Solving

The Reimbursement Specialist - Cash Applications will be expected to:

  • Anticipate issues, research, and implement creative solutions.
  • Work independently and as part of a team environment.
  • Be a self-starter, able to work with little to no direct supervision.
  • Be dependable and adhere to deadlines.
  • Utilize strong organizational and problem-solving skills, including being solutions-oriented and able to communicate a sense of authority through subject matter expertise and resourcefulness.
Salary and Benefits

The salary range for this position is $45,000 annually, with a comprehensive compensation and full benefits package offered by Pentec Health, including medical, dental, vision, 401k match, PTO, paid holidays, disability and life insurance, employee assistance, flexible spending or health savings account, and other additional voluntary benefits.

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