Full-Time Reimbursement Specialist - Follow Up & Appeals

• Tracking, reporting and addressing complex outstanding claims.
• Troubleshoot EOBs, appeal non-covered & low pay claims, follow-up on claims.
• Manage documentation for payer communication, correspondence, and insurance claim research.
• Accurate data entry into computer systems.
• Provide reimbursement assistance to patients.
• Verify and communicate insurance eligibility, billing, collections and payment responsibilities.
• Interpret EOB’s for follow-up and appeals.
• Follow HIPAA guidelines.
• Work well in a team environment.

• 1-3 years of recent experience in professional and facility coding, follow up & appeals, billing, and collections.
• Experience with insurance carriers on denials, filing reconsideration requests, formal appeals, and negotiations.
• Experience working with a broad range of payers and have appealed to state-level agencies or external-level review with IRO/IRBs.
• Basic math skills to interpret payment & adjustment transactions (EOB).
• Proficient using a computer, and data entry, and have above average typing skills.
• Intermediate to advanced MS Office including Excel.
• Familiarity with laboratory billing, Xifin, EDI enrollment, payer portals, and national as well as regional payers is a plus.
• High school diploma or equivalent.

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