• Billing & Reimbursement Specialist

    Rochester Regional Health (Rochester, NY)


    Job Title: Billing & Reimbursement Specialist

     

    Department: Billing

     

    Hours Per Week: 40

     

    Schedule: Monday - Friday, 8:30 AM - 5:00 PM

    SUMMARY

    The Billing and Reimbursement Specialist is responsible for timely processing of medical claims for DRUGSCAN.

    RESPONSIBILITIES

    + Process current and aged denials to improve cash collections and reduce DSO through timely follow up.

    + Contact third party payers on a timely basis to obtain claim processing status and clarification regarding un-responded or partially responded claims.

    + Analyze and report trends based on data analysis.

    + Consistently reduce AR > 90 to increase cash and lower bad debt

    + Maintain payer issue and resolution sheet to report to Director.

    + Drive efficiencies and improvements to streamline process and increase customer satisfaction.

    + Mail out HCFA claim forms daily.

    + Respond to any requests from third party insurance for any additional information and documentation.

    + Interact with department team members to resolve billing issues in a positive and constructive manner.

    + Answer phones and respond to inquiries or problems in a professional and courteous demeanor with clients, patients or insurance carriers.

    + Investigate insurance and patient refunds.

    + Verify patients’ coverage and benefits.

    + Adhere to appropriate quality control and confidentiality/HIPAA procedures.

    + Assist on special projects when needed.

    + Perform all other duties as assigned by supervisor/management.

    REQUIRED QUALIFICATIONS

    + 2-3 years of medical billing experience required, preferably in a laboratory setting

    PREFERRED QUALIFICATIONS

    + Associates degree in Accounting, Finance, or related field

    PHYSICAL REQUIREMENTS:

    S - Sedentary Work - Exerting up to 10 pounds of force occasionally Sedentary work involves sitting most of the time, but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.

     

    Rochester Regional Health is an Equal Opportunity/Affirmative Action Employer. Minority/Female/Disability/Veterans by a prospective employee and/or employee’s Physician or delegate will be considered for accommodations.