Reimbursement Specialist- Florida
4 days ago
Job Grade: 4
Purpose of job:
The Reimbursement Specialist is responsible for managing outstanding worker's compensation claims by collecting payments, resolving billing issues, and minimizing the number of uncollectable accounts. The ideal candidate will be results-driven and able to focus on key performance metrics to ensure quality and efficiency standards set forth by the company are met.
Main Duties
- Contact insurance payers, employers, or responsible parties in an effort to collect on outstanding accounts receivables.
- Identify and resolve improper payments, incorrect denials, billing errors and payer discrepancies.
- Compile accurate and effective appeals and disputes to the appropriate payers and state divisions.
Ensure individual and department goals are met, specifically:
Reduce the number of past due accounts through timely follow-up;
- Reduce the number of past due accounts through escalation and claim resolution;
- Increase cash performance through effective and persuasive collection attempts;
Reduce the number of days in AR for uncollectable accounts
Research, compile, maintain and manage quality data related to collection efforts.
- Provide feedback to management regarding payer issues, underpayments and denial trends.
Requirements:
Qualifications:
- High school diploma or equivalent
- General Office Knowledge (Microsoft Excel and Word)
- Proper phone and email etiquette
Knowledge, Skills and Abilities:
- Ability to review, analyze and interpret payor reimbursements, billing guidelines, and state or federal regulations.
- Detail oriented, with strong analytical, organizational and problem solving skills.
- Communicate professionally and effectively with employers, insurance payers, and UHS customers.
- Demonstrates a strong work ethic by managing time effectively and completing all tasks as assigned.
- Ability to balance productivity with a high-quality level of work standards.
- Adaptable with the ability to learn and apply knowledge of new programs and procedures quickly.
- Maintain confidentiality and appropriate HIPAA compliance guidelines.
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