Reimbursement Specialist - Recreate Behavioral Health Network

Recreate Behavioral Health Network is searching for a Reimbursement Specialist to join our team of healthcare professionals. We are currently beginning the talent search and vetting process. The Reimbursement Specialist must be very organized and an incredible multi-tasker, must have the ability to challenge insurance denials and have claims processed for payment. Behavioral health background is a plus, but not needed to apply.

Responsibilities Include, but are not limited to:

Working directly with the billing team lead on: Daily tasks, Workflow, A/R Spreadsheet, Refund request, Retractions, Payment follow-up, Medical Records/ Appeals Requests.

Specialists must complete tasks in a timely manner and be accurate by following-up with third-party payers for outstanding accounts receivables and insurance reimbursements.

Read notes carefully, research: patient’s benefits and claim for denials and/or past due.

Document all claims for proper follow-up and understanding if assistance is needed.

Ability to work on a schedule and prioritize workload, identify key projects that will result in reduction of outstanding accounts receivable with the billing team.

Be willing to call third-party payers concerning claim rejections, denials, and payment inconsistencies and make sure call follow-up satisfies the department requirements.

Accurately document all relevant medical claims, Spreadsheets, and actions for audit and tracking.

Taking ALL appropriate/needed steps towards claim resolution for proper reimbursements.

Ability to organize and maintain appropriate schedules for claims follow-up calls with third-party payers.

Ability to understand, request and file appeals for proper claim reimbursements.

Develop expertise and payer-specific knowledge on all aspects of medical claim collections.

Identify and report collection trends and/or issues resulting in delayed claim adjudication.

Interpret explanation of benefits for accuracy and correct payer adjudication.

Communicate and collaborate with team members concerning payer payments and denial trends.

Excellent communication and have a team-oriented mentality.

Ability to work with other collection specialists to create collective team advancements.

Collaborate with the RCM management on collection strategies and achieve department goals.

Ability to assist with special projects regarding collections with the RCM management team.

Monitor insurance claims and contacting insurance companies on the facilities behalf.

Collecting on all insurance claims for correct reimbursement of services rendered to our facility.

Respond to insurance companies regarding claims or account status.

Participate in a billing and collection related meetings to discuss new and on-going account resolution

Required Skills

Ability to hand and field all insurance phone calls in regards to claims status

Knowledge of billing procedures and collection techniques

Excellent understanding of AR processes

Ability to read and understand EOBs

Experience using medical billing software- Collaborate MD

Ability to prioritize tasks properly

Organized and able to multitask

Excellent verbal and written communication skills

Proficient in Microsoft Office Suite (Excel, Word, PowerPoint, Outlook)

Answer multi-line telephones

Exhibit patience and compassion

Self- directed with ability to work with minimal supervision

Understanding of being HIPAA Compliant with all patient information

Job Type: Full-time 

Benefits:

• Health Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance

Education:

• High school or equivalent (Preferred)

Experience:

• Medical Billing: 2 years (Preferred)

Schedule:

• 8 hour shift

Work Location: In person