Accounts Receivable Reimbursement Specialist

We are seeking a detail-oriented and experienced Accounts Receivable Reimbursement Specialist to join our team. The primary responsibility of this role is to coordinate and maintain the professional reimbursement program, ensuring compliance with current payment, billing, and collection regulations. The Accounts Receivable Reimbursement Specialist will play a vital role in maximizing reimbursement of services by accurately using codes and staying up-to-date with reimbursement/payment rules and policy guidelines. Additionally, this role involves managing Accounts Receivable, reviewing claims, addressing customer inquiries, and collaborating with various stakeholders to ensure efficient revenue cycle management. The ideal candidate should possess strong analytical skills, a thorough understanding of medical billing processes, and a commitment to compliance with industry regulations.

• Coordinate and maintain the professional reimbursement program, ensuring compliance with current payment, billing, and collection regulations.
• Monitor and evaluate reimbursement/payment rules and policy guidelines, staying updated with legislative and regulatory changes impacting medical billing.
• Prioritize and work on Accounts Receivable (A/R) by pulling and reviewing assigned caseloads, focusing on high balance and timely filing limit invoices. Work towards achieving a zero balance through resubmission of corrected claims, adjustments, or appeals.
• Review authorization, detailed prescriptions, and verification for claims within assigned caseload to ensure accurate and clean claims are submitted for revenue.
• Confirm and prioritize pick-ups, exchanges, and returns of serialized and non-serialized equipment and supplies to maintain inventory integrity and operational efficiency.
• Review and follow up on improperly paid or processed claims in a timely manner to avoid write-offs.
• Identify trending payor and payment problems, escalate them to management for global resolution.
• Request adjustments, write-offs, or refunds from supervisor in compliance with company standards.
• Work on reports such as daily denials, monthly A/R report, and task queue in addition to handling incoming correspondence from payors.
• Respond to customer inquiries in person, by phone, fax, or email, addressing payment inquiries, benefit questions, and insurance policy-related queries.
• Assist Cash Application Specialist with questions and inquiries related to A/R activities.
• Practice and adhere to all HIPAA, HQAA, and Compliance rules and regulations.
• Perform other duties as assigned by management.

• Minimum of 3 years of experience in medical billing or related field, with a strong emphasis on Accounts Receivable and reimbursement.
• DME experience preferred.
• Thorough knowledge of reimbursement/payment rules, coding practices, and regulatory requirements.
• Proficient in utilizing billing software systems and navigating various reports and portals.
• Strong attention to detail and analytical skills to identify discrepancies and resolve billing issues.
• Excellent communication and interpersonal skills for effective collaboration with internal and external stakeholders.
• Ability to prioritize tasks, work independently, and meet deadlines.
• Proficient in using Microsoft Office Suite and other relevant software.
• Familiarity with HIPAA, HQAA, and Compliance rules and regulations.
• High level of professionalism, integrity, and commitment to maintaining confidentiality.

If you possess the required qualifications and are eager to contribute to our organization's success, we invite you to apply for the position of Accounts Receivable Reimbursement Specialist.Practice and adhere to all HIPAA, HQAA, and Compliance rules and regulations.