Reimbursement Support - QA
Plano, Texas | Contract To Hire
The Reimbursement Support role is to document and confirm all correspondence and appeals from the reimbursement team is in compliance and correct prior to being sent to facilities, insurance companies and/or patients.
KEY ACCOUNTABILITIES/ESSENTIAL FUNCTIONS
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Understands medical billing requirements for Medicare, Medicaid, contracted and commercial payers
• Receives, logs, reviews and returns (as applicable) all insurance correspondence to responsible reimbursement specialist, annotating necessary corrections to be made prior to being mailed
• Determines proper postage and mails outgoing team correspondence
• Receives all faxes for reimbursement team and distributes to assigned specialist based on the work list
• Receives and logs all incoming medical records and distributes to requesting specialist
• Logs and reviews all negotiations received
• Composes counter offer based on precedence for that carrier
• Identifies new carriers and works with management to determine acceptable reimbursement levels
• Records all actions on Advanced MD
• Regular and timely attendance
• Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations
• Dependability: The employee can be depended upon to complete work in a timely, accurate, and thorough manner and is conscientious about assignments. Being dependable also includes promptness, regular attendance and compliance with work/departmental policies, procedures and protocols.
• Communication & Contact: The employee communicates effectively both verbally and in writing with superiors, peers, and individuals inside and outside the Company.
• Relationship with Others & Attitude: The employee works effectively and relates well with others including superiors, peers, and individuals inside and outside the Company. The employee exhibits a professional manner in dealing with others and works, to maintain constructive working relationships.
SKILLS AND ABILITIES
• Excellent computer skills (Microsoft Office Suite)
• Ability to type a minimum of 50 wpm with no errors
• Ability to work independently
• Ability to multi-task
• Consistent attention to detail and follow-up
• Display excellent judgment at all times
• Ability to work overtime if needed
REQUIRED EDUCATION AND EXPERIENCE
• High school diploma or GED required
PREFERRED EDUCATION AND EXPERIENCE
• 1-2 years’ experience in health/medical billing and collections
• Knowledge of Medical Terminology