Medicare Reimbursement Specialist

RPC - Dallas, TX

Full-time - Entry Level

Dallas, TX

Motor Vehicle and Parts Dealers

About the position

The Reimbursement Specialist will manage the reimbursement process within a healthcare setting, ensuring accurate billing and coding while facilitating payment collections from insurance companies and patients. This role is essential for maintaining compliance with healthcare regulations and improving financial management in patient care.

Responsibilities

• Review and process medical claims for accuracy and completeness.
• Utilize knowledge of medical billing and coding to ensure compliance with regulations.
• Conduct follow-ups on outstanding claims and resolve any discrepancies or issues.
• Collaborate with healthcare providers to gather necessary documentation for claims processing.
• Maintain organized records of all transactions, communications, and follow-ups related to reimbursements.
• Stay updated on changes in healthcare regulations, coding practices (including ICD-10), and reimbursement policies.
• Assist in the development of procedures to improve efficiency in the reimbursement process.
• Provide support in medical collections as needed, ensuring timely payment from patients and insurance providers.

Requirements

• Proven experience in medical billing, coding, or related fields is preferred.
• Familiarity with DRG (Diagnosis Related Group) systems is a plus.
• Strong understanding of medical terminology and medical records management.
• Proficient in using electronic health record (EHR) systems and billing software.
• Excellent attention to detail with strong analytical skills.
• Ability to communicate effectively with healthcare professionals, insurance representatives, and patients.
• Knowledge of ICD-10 coding standards is highly desirable.
• High school diploma or equivalent; additional certification in medical billing or coding is a plus.

Nice-to-haves

• Experience with Medicare reimbursement processes.
• Certification in medical billing or coding.

Benefits

• Competitive salary based on experience.
• Opportunity for contract extension based on performance.