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Healthcare Reimbursement Collections Representative

Sincerus Solutions Lexington, MA

  • Expired: over a month ago. Applications are no longer accepted.
Job Description

JOB SUMMARY:

  • Reimbursement Representative is responsible for accurate claims submission and accurate payment of claims according to Health Plans.

MAJOR DUTIES AND RESPONSIBILITIES:

  • Assures billing processes are compliant with payer requirement for Government, Commercial Health Plans and Medical Group payers.
  • Assures accurate billing of coding and units required by payer and therapy type
  • Analyze and rectify claims issues with payers by timely follow u of claim status/payment.
  • Ensures accuracy and completeness of payer requirements prior to timely submission of claims to Health Plans, either electronic or hard copy.
  • Assures required authorizations and medical documentation forms are in correspondence with claim submission for quick turn-around time
  • Reviews and assures claims are processed and paid in full according to contractual agreements.
  • Ensures revenue is booked according to appropriate contract allowables.
  • Communicates with branches and other departments to assure resolution of reimbursement issues.
  • Communicates and addresses reimbursement issues with management for resolution in a timely manner.
  • Handles collections calls promptly with professionalism to payers and/or patients.
  • Must be able to prioritize, multi-task, meet goals and deadlines.
  • Protects patient health information by following regulations for HIPAA compliance.
  • Ensures daily productivity is met and monthly and monthly closing goals are met.
  • Performs other related duties as directed by Supervisor.

EDUCATION AND/OR EXPERIENCE:

  • High School Diploma or equivalent education.
  • Candidate must be experienced with a minimum of 1-2 years (not including school or externship) in Home Infusion
  • Knowledge and understanding of HCPC and CPT codes
  • Candidate must be a self-starter and motivated to research and resolve issues
  • Ability to work independently with minimal supervision and prioritize to meet deadlines, as well as ability to work in a collaborative manner
  • Strong understanding of insurance terms, medical terminology, pricing methodologies for commercial and government billing requirements.
  • Proven solution-oriented attitude
  • Microsoft Word and Excel

INTERPERSONAL RELATIONS/TEAMWORK:

  • Demonstrates positive interpersonal relations in dealing with supervisors, co-workers and other employees so that productivity and positive employee relations are maximized.
  • Exhibits a positive attitude toward the organization, his/her job and others.
  • Shows concern and respect for others by dealing with people in a compassionate, sensitive and responsive manner.
  • Promotes change and is proactive in suggesting change and new ways of doing things.
  • Respects the confidentiality of others.
  • Complies with company policies including employee handbook, quality improvement and safety guidelines.

Sincerus Solutions

Address

Lexington, MA
02421 USA

Industry

Healthcare

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