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Medical Reimbursement Specialist

Plano, TX

Posted: 04/15/2019 Employment Type: Contract-Hire Industry: Healthcare Job Number: A Pay Rate: $18.00 /hour

Local growing company is seeking a Medical Reimbursement Specialist to join there TEAM. This is a 90-day contract with option to hire.

  • Reviews EOB/EOMB’s for proper reimbursement. 
  • Responsible for all collection activities on identified accounts.
  • Resolves electronic claim rejections and Explanation of Benefits denials promptly.
  • Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment.
  • Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed.  Provides insurance carriers with the requested information to facilitate payment.
  • Regularly contact Medicare, Medicaid and Commercial payors for a resolution to claims not paid or claims not paid according to plan benefits.
  • Performs claim appeals as required.
  • Assists with credit balance resolution.
  • Completes re-bill request as necessary to facilitate timely and proper claims payment.
  • Follows up on unresolved account balances including RTP’s.
  • Prepares adjustment and write-off requests as necessary.
  • Performs other duties and responsibilities as required or assigned.
  • Monitors all contracts and single patient agreements to ensure that appropriate reimbursement is received.

 

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