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Billing and Reimbursement Specialist
The Billing and Reimbursement Specialist is assigned a group of dialysis facilities and is responsible for the accurate and efficient billing and collecting of health insurance payments from insurance carriers. The Billing and Reimbursement Specialist coordinates, documents, and communicates with health insurance representatives in regard to proper insurance payments in accordance with policies and procedures, and current federal, state and local standards, guidelines, and regulations.
Essential Functions
- Responsible for accurate billing and collecting of revenue for respective financial classes.
- Obtains and tracks claim status via phone and online portals.
- Composes and follows up on claims appeals.
- Appropriately identifies, addresses, submits and processes adjustments.
- Reviews and understands Explanation of Benefits.
- Builds effective relationships with insurance carriers and representatives.
- Allocates coinsurance and deductibles timely and appropriately within applicable database.
- Responsible for reviewing and addressing incoming mail correspondence.
- Communicates effectively with patients regarding insurance checks.
- Communicates and collaborates with other internal departments.
- Completes and maintains facility reports on a regular basis and reviews for any issues.
- Maintains strict confidentiality of patient personal information.
- Maintains HIPAA compliance.
- Understands business implications of decisions.
Position Type, Expected Hours of Work & Travel
This is a Full-Time, hybrid, remote, or on-site position based in Beverly, MA or Franklin, TN. Days and hours of work are Monday through Friday, between 8:00 a.m. and 4:30 p.m. Hours of work may vary based on business needs. Travel is not expected with this position.Â
Required Education and Experience
- Bachelor’s degree in Business or Healthcare Management strongly preferred.
- 0-2 years of experience as a Billing and Reimbursement Specialist, or equivalent work experience as an insurance collector required.
- Experience in dialysis and healthcare is preferred.
- Must be highly organized and capable of handling and maintaining sensitive and confidential information.
- Excellent customer service skills, ability to actively contribute as a team player and superior attention to detail required.
- Ability to work in a fast-paced environment while maintaining high standards of accuracy required.
- Flexibility and ability to prioritize while alternating between tasks.
- Adaptability and willingness to consistently learn new skills.
- Proficiency in Microsoft Office Suite required.
Equal Opportunity Employer:
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Innovative Renal Care is an equal opportunity employer and a drug free workplace. All qualified We applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability, or protected veteran status. Â
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Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities
The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)
