Reimbursement Specialist

1 week ago

Green Bay, Wisconsin, United States a0-dc47-43ae-ada4-a3ee47df9138 Full time $40,000 - $60,000 per year

Come work where passion, quality, vision, professionalism, and synergy are valued BayCare Clinic's mission is to provide measurably superior specialty medical services to our patient
BayCare Clinic Corporate Headquarters is looking for a Reimbursement Specialist to join our team in Green Bay, WI.
We're looking for a detail oriented, thoughtful candidate who wants to contribute to a positive experience for all our patients. This role is full time, between our core hours, Monday-Friday between 8:00 a.m. - 5:00 p.m. No Holidays No Weekends

The Clinic
BayCare Clinic is a successful, dynamic group comprised of 19 specialties. We are a physician-owned entity with joint ownership in Aurora BayCare Medical Center, a 167-bed hospital located in Green Bay, WI, offering us a built-in referral base. Each of our specialty practices have clinical autonomy and are financially sound.

BayCare Clinic offers part-time and full-time employees a comprehensive benefits package including health, dental, disability and life insurance, as well as flexible spending options. We also offer a 401k retirement plan with a company match, generous PTO, and paid holidays.

The Team
The unique skills and talents of each member of our team contributes to our synergy and our overall goal of providing our patients with excellent care. We believe in the power of a positive, collaborative culture, and we strive to provide a supportive and energizing work environment.

Every member of our team has a voice and is trusted to have ownership over their work. To encourage this, we provide regular opportunities for professional development, we seek out feedback and ideas, and we invite participation on a variety of projects.

The Job

  • Perform detailed audits timely, and as defined by Bay Care reimbursement contracts.
  • Responsible for accurate and timely preparation, review, submission, and follow-up of claims.
  • Contacts payers via website, telephone, and/or correspondence regarding reimbursement.
  • Review both underpayments and overpayments to identify payment trends or missed revenue opportunities.
  • Reviews incorrect discounts received from Payment Posting.
  • The ability to work reports, follow-up and provide updates when needed.
  • Responsible for the specific details regarding projects you are assigned too.
  • Stays current with payer specifics and contracts regarding reimbursement.
  • Follow up and place outbound calls to challenge payments and or reconsideration.
  • Identify problem payers and notify management of issues in a timely manner.
  • Respects and maintains confidentiality.
  • Works in a safe, compliant, and ethical manner always.

The Requirements

  • A minimum of a high school education or equivalent.
  • Post high school coursework in Medical Terminology, Healthcare Business Services, or Office Assistant is appropriate.
  • Must have a working knowledge of medical terms and health insurance.
  • Must possess strong desktop computer skills.
  • Experience with EPIC electronic medical records system is preferred.
  • Prior experience in a medical setting is preferred.

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