Reimbursement Specialist
6 days ago
Adventist HealthCare is seeking an experienced Reimbursement Specialist to join our Patient Financial Services Department. As a Reimbursement Specialist, you will play a critical role in ensuring timely and accurate payment of patient claims.
Key Responsibilities:- Establish payment status of billed or partially paid claims
- Determine root cause of denial or partially paid claim
- Contact payer to determine additional information needed for adjudication
- Obtain payment or commitment from payer
- Obtain status on billed, resubmitted, appealed, and reconsideration claims
- Determine if claim is on file
- File appeal after review of denial indicates appeal is needed
- Request rebill/corrections if denial has been reviewed
- Contact payer if denial was inappropriate or additional information is needed
- Route denial to appropriate team
- Route claim to biller when no claim is on file
- Transfer unpaid balance to patient
- Review Explanation of Benefits for clarity
- Process payer changes as needed
- High School Diploma required, or some college preferred
- Minimum of 3 years' experience in healthcare environment
Day Shift (Hybrid) Monday - Friday, 8:30 am - 5:00 pm
Adventist HealthCare offers a competitive benefits package, including health, disability, and life insurance, as well as a 403(b) retirement plan. We also offer flexible spending, legal, and pet insurance to meet the needs of employees and their eligible family members.
As a faith-based organization, Adventist HealthCare has a reputation for high-quality, compassionate care. We are committed to attracting, engaging, and developing the best people to cultivate our mission-centric culture.
Adventist HealthCare is an Equal Opportunity/Affirmative Action Employer. We welcome applicants from diverse backgrounds and are committed to creating a welcoming, equitable, and safe place to work and grow for all employees.
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Gaithersburg, Maryland, United States Adventist HealthCare Full timeReimbursement Specialist Job DescriptionAdventist HealthCare is seeking an experienced Reimbursement Specialist to join our Patient Financial Services Department. As a Reimbursement Specialist, you will play a critical role in ensuring timely and accurate payment of healthcare claims.Key Responsibilities:Establish payment status of billed or partially paid...
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