Reimbursement Specialist

2 weeks ago

Memphis, Tennessee, United States Baptist Memorial Full time

Overview:
As a Reimbursement Specialist at Baptist Memorial, you will play a crucial role in enhancing the collection of accounts receivable through meticulous benefits verification and effective communication regarding authorized services. Your expertise will ensure the accurate submission of claims, secondary billing, and prompt follow-up on outstanding accounts to help the organization achieve its financial objectives.

Key Responsibilities:
1. Prepare and submit precise invoices to payors in accordance with established guidelines to guarantee payment for services rendered and supplies provided.
2. Gather payor information, confirm coverage, and obtain necessary authorizations as mandated by each payor source, while effectively communicating with relevant stakeholders as per policy.
3. Address denials, incorrect payments, and non-payments by scrutinizing available documentation and taking the necessary steps to collect or amend the account.
4. Execute write-offs and adjustments following established protocols to maintain the integrity of accounts receivable.
5. Resolve charges on hold by promptly reviewing billing releases and tracking documentation, taking appropriate actions to facilitate the release of bills for submission to payors.
6. Assess expiring prior authorizations for services, coordinating with payors, physician offices, and clinicians to extend authorizations or discontinue services as needed.
7. Review medical documentation and claims prior to billing to ensure compliance with corporate billing regulations (Medicare, Medicaid, state programs, etc.).
8. Achieve all assigned performance goals.

Qualifications:
Education:
Minimum: Proficient communication skills in standard English, both written and verbal, to ensure high productivity and efficiency.
Experience:
Preferred: Background in Billing/Accounts Receivable, particularly in healthcare settings.
Minimum: At least one year of business experience.
Special Skills:
Preferred: Familiarity with medical terminology and basic proficiency in Microsoft Office, including Excel and Word.

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