Medical Reimbursement Expert

7 days ago


Brooklyn, New York, United States The Brookdale Hospital Medical Center Full time

Company Overview

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The Brookdale Hospital Medical Center is a leading healthcare provider, dedicated to delivering exceptional patient care and service.

Job Summary

We are seeking an experienced Clinical Billing Specialist to join our team. This role will be responsible for obtaining appropriate reimbursement levels for professional services by analyzing denial and rejection reports and appeals whenever appropriate.

About the Role

As a Clinical Billing Specialist, you will work directly with practices, payors and patients to resolve claims. You will address core issues driving denials or slow payments with appropriate staff, assist in charge capture and charge entry if necessary, and develop expert knowledge of AthenaHealth practice management system.

Key Responsibilities

  • Review and clear hold buckets for professional fee claims
  • Develop relationships with key payor representatives for timely claim adjudication
  • Develop relationships with practice plan personnel to assist in rectifying registration and coding related denials, and to acquire additional documentation for appeals
  • Maintain a working knowledge of CPT-4 and ICD-9/10-CM coding principles, governmental regulations, protocols and third-party requirements pertaining to billing and documentation
  • Answers patient and/or payor questions regarding billed amounts
  • Provides accurate and concise communication to practices informing them of best practices
  • Ensures maximum efficiency and reimbursement for properly documented services
  • Reviews, modifies, and recommends changes to policies and procedures to improve professional fee billing and to maximize reimbursement
  • Effectively manager A/R, bad debt, credit balance/refunds and collections
  • Patient services and mails (sort and distribute)
  • Reconcile all payments (Bank, copayment) and produce financial month end reports
  • Track, scan and upload payments to Athena
  • Obtain Insurance Web access for all facilities (web portal, set up ERA/EFT, etc.)

Requirements

To be successful in this role, you will need:

  • An Associate's Degree or equivalent experience
  • Prior experience using AthenaHealth practice management or similar physician practice management system
  • Minimum three (3) years of professional fee reimbursement experience
  • Familiarity with physician practice management software (AthenHealth, EPIC, etc.) and electronic medical record a plus

What We Offer

We offer a competitive salary range of $60,000 - $80,000 per annum, depending on experience, as well as a comprehensive benefits package including health insurance, retirement plan, and paid time off.

Contact Us

If you are a motivated and detail-oriented individual with excellent communication skills, we encourage you to apply for this exciting opportunity.



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