Reimbursement Specialist_Medical Ins. Collections

The Start Center For Cancer Care - San Antonio, TX

Full-time - Mid Level

San Antonio, TX

Hospitals

About the position

The Reimbursement Specialist at The START Center for Cancer Care is responsible for managing the review, research, and collection of outstanding accounts receivable. This role ensures that accounts are paid and posted correctly, while also making recommendations for write-offs when necessary. The ideal candidate will have experience in medical collections, particularly with private pay collections and credentialing, and will work closely with various teams to facilitate patient collections and resolve billing inquiries.

Responsibilities

• Reviews, researches and collects all outstanding accounts receivable for assigned payer(s) including primary, secondary, and tertiary insurance claims.
• Reviews, corrects, and resubmits all denials for assigned payer(s).
• Recognizes appeal opportunities and submits appeal letters along with appropriate documentation to insurance companies.
• Communicates clearly with the Financial Assistance team and satellite offices to facilitate patient collections and drug replacement as appropriate.
• Reviews accounts for necessary payment refunds and/or charge corrections.
• Assists patients, payers, and internal customers in resolving accounts receivable questions.
• Ensures payments are posted according to contracts on assigned accounts and notifies Supervisor/Manager of any contract issues arising from payments received.
• Performs other duties as assigned.

Requirements

• High school diploma or GED
• 3-5 years of experience in medical billing and collections
• Experience in physician practice preferred
• ICD & CPT coding experience
• Knowledge of Medicare/Medicaid/Insurance guidelines
• Proficient in data entry and billing software
• Excellent oral and written communication skills
• Good organizational skills

Nice-to-haves

• Experience with Private Pay collections
• Credentialing experience