Medical Reimbursement Specialist
尼摩尔斯在弗洛伊西州杰克逊维尔寻求医疗补偿专家。医疗补助专业人员的主要职能是通过收费解决开放的保险余额。该职位负责研究未付款，低薪和拒绝的保险索赔，然后应用合同账单和支付指南以确保及时解决并达到收费目标。这是一个远程职位。申请人必须居住于以下几个州之一：阿拉巴马，科罗拉多，德拉华，哥伦比亚特区，佛罗里达州，格鲁吉亚州，伊利诺伊州，马里兰州，密苏里州，新泽西州，纽约，北卡罗来纳州，俄俄州，宾夕法尼亚州，南卡罗来那州，田纳西州，德萨斯州和弗吉尼亚州。基本功能 ·通过审查编码，发票，合同协议和授权条款来促进开放收益的解决。· 对拒绝和拒绝趋势进行诊断并向管理部门报告问题。·保持对索赔后续活动的准确文件。·处理客户服务会议的问题，包括但不限于处理调整请求，改变账户类型，根据企业指导方针收购担保人并存以及转让情况。·应对保险拒绝和支付不足，适当地调整余额和/或准确地将担保人的患者责任 facturizing. · 准确地将患者人口统计数据，保证人和覆盖信息输入 Epic 系统。· 正确改变申请订单，确保必要的调整在账户上列出，分配支付以正确的服务日期并要求变更如果需要。·了解和使用标准业务实践，跟踪所有保险和系统变化，表现出优秀的客户服务，促进病人，员工和客户满意度，反映了 Nemours 使命，愿景和价值观。要求高中文凭 1-3年相关经验原始发布于喜马拉雅山。
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Nemours is seeking a Medical Reimbursement Specialist in Jacksonville, FL
The primary function of the Medical Reimbursement Specialist is the resolution of open insurance balances through collections. The position is responsible for researching unpaid, underpaid and denied insurance claims then applying contractual billing and payment guidelines to ensure timely resolution and meet collection goals.
This is a remote position.Applicants must reside in one of the following states: Alabama, Colorado, Delaware, the District of Columbia, Florida, Georgia, Illinois, Maryland, Missouri, New Jersey, New York, North Carolina, Ohio, Pennsylvania, South Carolina, Tennessee, Texas, and Virginia.
Essential Functions
- Facilitate resolution of open receivables by review of coding, billing, contract agreements, and authorization terms
- Diagnose and report issues with regards to rejection and denial trends to management
- Maintain accurate documentation of claim follow up activities.
- Address inquiries on customer service encounters to include, but not limited to process requests for adjustments, account type changes, guarantor merges, and transfers when necessary according to enterprise guidelines.
- Address insurance denials and underpayments, appealing and/or adjusting balances as appropriate and accurately billing the guarantor for patient responsibility.
- Accurately enter patient demographics, guarantor and coverage information into Epic system.
- Accurately change filing order, ensure necessary adjustments are listed on account, distribute payments to correct service dates and request changes if needed.
- Know and use standard business practices, keep abreast of all insurance and system changes, demonstrate excellent customer service that promotes patient, staff and customer satisfaction, and reflects the Mission, Vision, and Values of Nemours.
Requirements
High School Diploma
1-3 years of relevant experience
Originally posted on Himalayas