Reimbursement Specialist

Description:

The Patient Account Representative is responsible for managing all aspects of accounts receivables to ensure maximum/timely reimbursement for services performed for hospital billing and claims. The patient account role will be responsible for keeping current on all payer specific regulations and procedures and will provide written summaries of findings and recommendations. This position is customer focused with emphasis on accounts receivable management. The Patient Account Representative is required to follow established guidelines, take action to recover delinquent accounts with the payers. Place calls to the payers to collect and assist in maintaining Network A/R days. Follow up maybe performed by way of payer websites when appropriate. This position will allow the flexibility to work from home upon completion of the initial training period.

Adheres to all network and departmental procedures and policies

Complies with applicable state/federal laws and the program requirements of accreditation agencies and federal, state and government health plans

Documents all actions taken on accounts in the system account notes to ensure all prior actions are noted and understandable by others

Ensures confidentiality of patient records

Follows appropriate steps to resolve denials within specified timeframe

Follows appropriate steps to resolve insurance correspondence scanned into mail queues

Follows billing and collection procedures as outlined in policies and provides payers with the appropriate and necessary information to adjudicate claim

Maintains A/R to meet Network set goals

Meets productivity standards designated by the department

Meets QA standards designated by the department

Monitors the billing and follow up holds at all sources, ensures timely resolution and is responsible for keeping assigned tasks current

Participates in monthly conference calls with specific payers

We're partners in transformation. We help clients activate ideas and solutions to take advantage of a new world of opportunity. We are a team of 80,000 strong, working with over 6,000 clients, including 80% of the Fortune 500, across North America, Europe and Asia. As an industry leader in Full-Stack Technology Services, Talent Services, and real-world application, we work with progressive leaders to drive change. That's the power of true partnership. TEKsystems is an Allegis Group company.

The company is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.