Reimbursement Specialist

Description Support PPMW's Revenue Cycle activities by performing all billing and collection functions for selected payer groups/financial classes, including posting and follow up on all outstanding Accounts Receivables (A/R). Provide feedback as appropriate to improve affiliate performance and increase reimbursement. Active participant in meetings with affiliate(s). Complete billing special projects as assigned. Requirements Conduct appropriate claim follow-up on all open A/R to ensure prompt adjudication. Perform daily ERA, EOB, and patient payment posting. Submit daily electronic and paper claim files, and correct all claim and charge review edits, warnings and errors; run statement files; and download ERAs/EOBs as needed. Review and monitor clearinghouse claim errors and global payer rejections for possible system edits or payer updates. Daily review of billing work queues. Credit balance review and processing. Insurance benefit verification. Analyze payer denial trends and payer coding requirements to ensure payment of claims. Ensure month-end activities are completed in a timely manner and that month-end reconciliation is accurately completed. Ensure the affiliate's claim KPIs are satisfied. Participate in Revenue Cycle Team meetings/conference calls, and provide the necessary reporting, feedback, and training required to improve processes. Serve as an active agent on the billing line. Attend PPMW and PPFA training as well as other assigned training to improve knowledge base and claim efficiency. Follow up on denied claims with payers. Patient statement processing. Grant billing. Complete special projects as needed. Other responsibilities as assigned. Qualifications: Bachelors degree preferred, high school diploma or equivalent required Three or more years' experience in medical billing and/or Accounts Receivable Epic experience preferred Ability to work independently, prioritize work, and communicate effectively. Experience with patient billing and collections. Ability to handle confidential materials that relate to a variety of individuals. Ability to thrive in a fast-paced environment. Superb attention to detail. Strong problem-solving skills. Ability to work independently, including handling multiple projects/tasks simultaneously. Access to secure, reliable Internet and utilities.

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