Reimbursement Specialist - Medicare/Medicaid

About the position

The Medicare/Medicaid Reimbursement Specialist at Midwest Orthopaedics at Rush is responsible for managing Medicare collections and ensuring effective communication with patients and insurance companies. This role requires a strong understanding of billing processes and the ability to work in a fast-paced environment, providing high-quality customer service while handling account inquiries and claims management.

Responsibilities

• Answer incoming calls into the call center and assist patients/insurance companies with account questions in a courteous and timely manner.
• Ensure patients/insurance companies understand the billing statements and processes to provide the highest level of customer care.
• Facilitate follow-up communications with insurance companies and patients regarding claim/payment status through practice management system and reporting tools.
• Document all actions and maintain a permanent record of patient accounts to ensure a sufficient audit trail.
• Review and adjust balances according to fee schedules and management/MD requests, verifying that claims have processed correctly by the insurance plan.
• Research and obtain necessary documentation for insurance companies to process outstanding claims.
• Identify denials and appeal with proper documentation within a timely manner to secure payment.
• Answer patients' questions regarding statements and insurance coverage.
• Telephone or email payers for follow-up on outstanding claims.

Requirements

• High school diploma or general education degree (GED).
• Minimum of 2 years Accounts Receivable/Collection experience in Medicare, preferably in an Orthopedic practice.
• Direct Medicare experience is highly preferred.
• Excellent interpersonal and communication skills.
• Ability to work independently and as part of a team in a fast-paced environment.

Benefits

• Comprehensive compensation and benefits package
• Opportunities for career growth and development