Position Title: Reimbursement Specialist
Department: Customer Care and Reimbursement
Location: Lauderdale, MN
Position Status: Temp to Hire
E-PHI Access: Full Access
Hours: 1st Shift 8-5pm
Salary Range: $17-21 DOE
THE RIGHT STAFF is looking for a Reimbursement Specialist that will be responsible for the claim submission process for all government and or commercial insurance claims for primary, secondary, and tertiary claims. The Reimbursement Specialist is responsible for claims follow up from submission to final payment, reviewing claim reports in the company computer system and taking action for needed corrections. Responsible for meeting established department and company goals and objectives.
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Duties and Responsibilities:
- Responsible for claim submission, claim resolution and follow up activities
- Responsible for checking status on submitted claims with insurance companies, and ensuring accurate processing claims
- Responsible for reviewing the patient’s account for accuracy prior to confirming orders
- Responsible for confirming orders in the company’s computer system
- Responsible for accuracy of claims data and coding. Determine proper claims codes such as diagnosis codes, unit and modifier codes, provider ID, physician information, or any additional information required, as they relate to specific insurance companies
- Assist reimbursement Supervisor in researching electronic submission procedures for specific insurance companies that are not already set up, and is responsible for updating web portal notices, bulletins, etc.
- Provide assistance to customers by responding to inquiries regarding claim payment status.
- Provide necessary follow-up throughout the claim process and update insurance company billing procedures as needed.
- Responsible for checking all reports on submitted claims through various websites, portals, and the companies computer system.
- Assist Reimbursement supervisor in cash flow projections, payment accuracy, EOB research and first level claim appeals and reconsideration requests.
- Assist with annual financial audit and other accreditation/ regulatory audits
- Interact with Finance department regarding potential write-offs and other accounts receivable questions or issues
- Attend HIPPA training and other training sessions as they arise
- Performance of additional duties as assigned
- High school diploma or GED
- Minimum 2 years of claims processing experience or previous claim clerical support preferred
- Great communication skills both verbal and nonverbal
- Attention to detail
- Ability to follow standard scripts and procedures
- Strong knowledge of word processing, spreadsheet and data base software.
- Strong math skills
- Demonstrated customer service skills
- Ability to develop skills necessary to understand and communicate insurance coverage and the claim process
- Ability to work independently and as part of a team
- Strong problem solving skills
Incumbent must be able to sit at a computer desk in front of a PC monitor for long periods of time. Position requires incumbent to use a PC, telephone, and basic office equipment. Position requires ability to hear phone conversations, read medical information and communicate clearly with all levels of internal and external customers. Must have ability to problem solve, work independently and or with a team.
Mon-Fri business hours approximately 8am-5pm.
THE RIGHT STAFF wants to help you succeed! We want to get to know you, your skills, interests, and goals. Our team of seasoned professionals works to match you to the best job, best fit, and best location. We provide interview coaching. We can connect you with some of the area’s leading employers. We are here to help you!
Temporary assignments to full-time permanent positions, THE RIGHT STAFF is ready to assist you! Let us help you create YOUR success!
We thank all interested candidates. However, only those selected for interviews will be contacted.