ASC Reimbursement Specialist

3 days ago


Birmingham, Alabama, United States NSN Revenue Resources Full time
ASC Reimbursement Specialist

We are seeking a highly skilled and detail-oriented ASC Reimbursement Specialist to join our team at NSN Revenue Resources. As a key member of our central billing office, you will play a crucial role in resolving outstanding surgical claims and ensuring maximum reimbursement for our ambulatory surgery centers.

Responsibilities:
  • Timely follow-up and resolution on all outstanding A/R, including unpaid, underpaid, and denied claims for all payers, including self-pay.
  • Prioritize high-dollar claim balances through work queues and review incoming insurance and patient correspondence, including refund requests.
  • Send appeals when necessary and provide requested medical documentation.
  • Review medical documentation to justify medical necessity and ensure accuracy of patient balances.
  • Take incoming patient phone calls to resolve inquiries, billing issues, or outstanding balances.
  • Review insurance payments and determine accuracy of reimbursement based on contracts, fee schedules, or summary plan documents.
  • Negotiate payment amounts for procedures with Third Party Administrators for out-of-network providers.
  • Recommend adjustments when applicable or recommend refunds for overpayments to insurance carriers or patients, providing the necessary documentation.
Requirements:
  • 2+ years of ASC revenue cycle or orthopedic collections experience is preferred.
  • Strong understanding of medical billing and insurance reimbursement processes, including experience with denials and appeals.
  • Ability to read and interpret insurance explanations of benefits and managed care contracts.
  • Excellent interpersonal and communication skills.
  • Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
  • Intermediate computer proficiency in Microsoft Office, including Excel and Outlook.
  • Advantx, Vision, HST, Waystar experience is preferred.
  • High School Diploma or equivalent.

We offer a competitive salary and benefits package, as well as opportunities for growth and advancement within our organization. If you have a passion for revenue cycle management and a commitment to ensuring timely and accurate payment for healthcare services, we encourage you to apply.

This is a remote position, but ASC facility billing experience is required to work from home.



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