Reimbursement Specialist

1 week ago


Alamogordo, New Mexico, United States Christus Health Full time
Job Summary

Christus Health is seeking a highly skilled Reimbursement Analyst to join our team. As a Reimbursement Analyst, you will play a critical role in ensuring accurate and timely reimbursement for our patients.

Key Responsibilities
  • Review and Analyze Payer Communications

Thoroughly review and analyze payer EOBs, payment accuracy, patient liability, and appeal grievances to ensure compliance with regulatory requirements.

File Appeals and Resolutions

File appeals on underpayments and work with payers to resolve discrepancies in a timely manner.

Generate Reports and Analytics

Utilize the Managed Care module to generate reports and analytics to identify issues, trends, and areas for improvement.

Collaborate with Management

Work closely with management to identify and resolve payer problem accounts and develop strategies to improve reimbursement rates.

Communicate with Payers and Patients

Effectively communicate with payers and patients to resolve issues and provide timely updates on reimbursement status.

Maintain Accurate Records

Enter detailed notes and explanations of account activity into the Patient Accounts system, including expected payment calculations.

Identify and Report Trends

Identify payer trends and report them to the Director and/or Assistant Director of Patient Financial Services.

Support Reimbursement Team

Assist the Reimbursement Specialist as needed to ensure seamless operation of the reimbursement process.

Provide Excellent Customer Service

Respond to patient inquiries, interdepartmental inquiries, and payer requests in a timely and professional manner.

Requirements
  • Education

High School diploma or equivalent required.

Licenses and Certifications

Certified Heartsaver (C-HS) certification preferred.



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