Reimbursement Specialist

1 week ago

Washington, United States Planned Parenthood of Metropolitan Washington DC Full time
Job DescriptionJob Description
Description:

Support PPMW's Revenue Cycle activities by performing all billing and collection functions for selected payer groups/financial classes, including posting and follow up on all outstanding Accounts Receivables (A/R). Provide feedback as appropriate to improve affiliate performance and increase reimbursement. Active participant in meetings with affiliate(s). Complete billing special projects as assigned.

Requirements:
  • Conduct appropriate claim follow-up on all open A/R to ensure prompt adjudication.
  • Perform daily ERA, EOB, and patient payment posting.
  • Submit daily electronic and paper claim files, and correct all claim and charge review edits, warnings and errors; run statement files; and download ERAs/EOBs as needed.
  • Review and monitor clearinghouse claim errors and global payer rejections for possible system edits or payer updates.
  • Daily review of billing work queues.
  • Credit balance review and processing.
  • Insurance benefit verification.
  • Analyze payer denial trends and payer coding requirements to ensure payment of claims.
  • Ensure month-end activities are completed in a timely manner and that month-end reconciliation is accurately completed.
  • Ensure the affiliate's claim KPIs are satisfied.
  • Participate in Revenue Cycle Team meetings/conference calls, and provide the necessary reporting, feedback, and training required to improve processes.
  • Serve as an active agent on the billing line.
  • Attend PPMW and PPFA training as well as other assigned training to improve knowledge base and claim efficiency.
  • Follow up on denied claims with payers.
  • Patient statement processing.
  • Grant billing.
  • Complete special projects as needed.
  • Other responsibilities as assigned.

Qualifications:

  • Bachelors degree preferred, high school diploma or equivalent required
  • Three or more years' experience in medical billing and/or Accounts Receivable
  • Epic experience preferred
  • Ability to work independently, prioritize work, and communicate effectively.
  • Experience with patient billing and collections.
  • Ability to handle confidential materials that relate to a variety of individuals.
  • Ability to thrive in a fast-paced environment.
  • Superb attention to detail.
  • Strong problem-solving skills.
  • Ability to work independently, including handling multiple projects/tasks simultaneously.
  • Access to secure, reliable Internet and utilities.




Compensation details: 22-30 Hourly Wage



PI37f4d1c9d70e-25405-36047176

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