We are looking for a Medical Reimbursement Specialist to join our client on a contract-to-hire basis in Langhorne, PA. This opportunity is ideal for someone who brings strong knowledge of insurance reimbursement, claims resolution, and payer compliance in a fast-paced medical billing environment. The person in this role will help improve collections performance by addressing outstanding claims, resolving denials, and supporting accurate reimbursement outcomes. You will work closely with internal teams to ensure billing activity is documented thoroughly and aligned with Medicare and commercial insurance requirements.
Responsibilities:
• Review outstanding accounts receivable and take timely action to secure payment on unresolved medical claims.
• Investigate denied or underpaid claims, identify patterns, and prepare well-supported appeals to improve reimbursement results.
• Apply Medicare and commercial payer guidelines to evaluate claim status and determine appropriate next steps for resolution.
• Partner with billing and operational team members to strengthen collection efforts and support shared performance goals.
• Use explanation of benefits details, billing records, and payer feedback to correct claim issues and reduce payment delays.
• Maintain complete and accurate account documentation to support follow-up activity and meet payer compliance standards.
• Leverage knowledge of medical terminology, coding elements, and modifier usage to resolve reimbursement discrepancies.
• Track reimbursement activity and account progress using reporting tools such as Microsoft Excel to support account management.
• Assist with high-volume billing and payment follow-up tasks while maintaining accuracy and productivity in an in-office setting.
• Prior experience in medical billing, payment posting, or accounts receivable follow-up within a healthcare setting.
• Strong working knowledge of Medicare regulations, insurance reimbursement processes, and payer-specific billing requirements.
• Ability to interpret explanation of benefits statements and use them to resolve claim and payment issues.
• Excellent written communication skills with the ability to draft clear, well-structured appeal letters.
• Advanced Microsoft Excel skills for tracking account activity, analyzing trends, and preparing reports.
• Solid understanding of medical terminology, billing codes, and modifier application related to reimbursement workflows.
• Strong analytical thinking, organization, and attention to detail in a deadline-driven environment.
• Ability to work effectively with cross-functional teams while managing assigned accounts with accountability.