Medicare Reimbursement Specialist

RPC - Dallas, TX

Full-time - Entry Level

Dallas, TX

Motor Vehicle and Parts Dealers

About the position

We are seeking a detail-oriented and knowledgeable Reimbursement Specialist to join our healthcare team. The ideal candidate will be responsible for managing the reimbursement process, ensuring accurate billing and coding, and facilitating the collection of payments from insurance companies and patients. This role requires a strong understanding of medical terminology, coding systems, and the ability to navigate complex reimbursement scenarios.

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

• Opportunity to improve patient care through effective financial management.
• Work in a supportive healthcare team environment.