Addus HomeCare - Frisco, TX
posted about 2 months ago
Full-time
Remote - Frisco, TX
1,001-5,000 employees
Ambulatory Health Care Services
About the position
The Reimbursement Specialist is responsible for managing billing and revenue cycle processes, including insurance benefit investigations, collections, authorization requests, and claim submissions. This role requires effective communication with various stakeholders to ensure proper reimbursement and access solutions for patients, while adhering to regulations and maintaining confidentiality.
Responsibilities
- Accurately interpret patient insurance, prescription, and health-related documentation.
- Conduct medical insurance verifications and investigations for commercial and government payors.
- Communicate with insurance companies, patients, providers, and prescribers to coordinate reimbursement and access solutions.
- Review unpaid accounts to determine status and take appropriate action to ensure payment.
- Review all claims for compliance and completeness for submissions.
- Research available alternative funding options to reduce patients' financial burden.
- Handle high call volumes effectively.
- Communicate with internal and external departments to facilitate coordination of care.
- Maintain a high degree of confidentiality due to access to sensitive information.
- Maintain regular, predictable, consistent attendance and be flexible to meet departmental needs.
- Follow all Medicare, Medicaid, and HIPAA regulations and requirements.
- Abide by all regulations, policies, procedures, and standards.
- Perform other duties as assigned.
Requirements
- High school diploma or equivalent is required; undergraduate degree is preferred.
- Experience in Medical Billing, Accounts Receivables, and/or Collections within a healthcare or insurance environment is preferred.
- Possess quick and accurate alpha/numeric data entry skills.
- Computer proficiency in MS Office and web-enabled applications strongly preferred.
- Customer service skills required.
- Understanding of the requirements of Medicaid, Medicare, and insurance billing is preferred.
- Ability to maintain positive internal and external customer service relationships.
- Ability to plan and organize work effectively and ensure its completion.
- Ability to meet all productivity requirements.
- Demonstrate team behavior and promote a team-oriented environment.
- Actively participate in Continuous Quality Improvement.
- Represent the organization professionally at all times.
- Self-starter with exceptional organizational and follow-through skills.
- Excellent verbal and written communication skills.
- Ability to work independently and in a team environment.
Benefits
- Dental insurance
- Employee discount
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
