The Spec II Reimbursement role is responsible for collecting on outstanding balances for a specific group of payors to help ensure maximum reimbursement. This position handles more complex reimbursement work, including payor research, root cause analysis, and problem resolution to support increased revenue.
The role works aged accounts, processes appeals and corrected claims, researches and reconciles credit balance accounts, and processes adjustments as needed. It also involves interaction with payers and internal management to ensure timely collections, collaboration with reimbursement specialists across the enterprise, and compliance with CLIA, HIPAA, and company compliance standards.
Qualifications
- High school diploma or GED required
- 3+ years of experience in medical billing or revenue cycle
- Proven track record of high performance
- Strong organizational, communication, multitasking, and teamwork skills
- Ability to work independently on collections, problem identification, and resolution
- Ability to escalate and resolve issues with payor supervisors, managers, and provider relations
- Strong professionalism and time management skills
- Ability to stay current on industry trends, regulatory changes, and best practices in medical billing and reimbursement
- Proficiency with medical billing software and electronic health records (EHR) systems
- Working knowledge of ICD-10 and CPT codes
Physical Requirements
- Light work, including exerting up to 20 pounds of force frequently
- Requires stationary positioning, movement, operating equipment, ascending and descending, communicating, observing, pushing or pulling, and reaching
Location
Utah, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
No
Posted
2 weeks ago