The Reimbursement Associate performs accounts receivable functions including qualification of appropriate documentation and billing. Helps ensures compliance with all government, contract, and company policies and regulations.
Essential Duties and Responsibilities include the following.
Checks and understand eligibility and verification requirements
Reviews claims using basic understanding of insurance coverage and criteria to help determine appropriate steps to submit payable claim
Researches overdue accounts and follows up by mail and/or phone to insurance carriers or customers on delinquent payments
Reviews denied or unpaid claims to determine proper resolution
Resubmits general claims with proper documentation for further carrier review
Responds to inquiries regarding account status in a timely manner
Understands billing software in order to review customer information and enter data
Maintains notes and documents progress appropriately and timely
Brings recurring issues to the attention of management
Performs other duties as assigned
Qualifications:To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience: High school diploma or GED equivalency. Prefer 3-6 months home health, customer service, call center, insurance, or reimbursement experience. Strong interpersonal, communication, and organizational skills required.
Computer Skills:To perform this job successfully, an individual should have basic computer and typing skills.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The employee must occasionally lift and/or move up to 10 pounds. The employee is frequently required to sit; use hands to fingers, handle, and feel; and talk and hear. The employee is occasionally required to stand and walk.