Reimbursement Specialist

4 Corner Resources is currently seeking a driven Reimbursement Specialist. This would be a 3-6 month contract. The ideal candidate should have proven experience in Part A billing and a demonstrated dedication to maintaining accuracy, efficiency, and compliance with regulatory standards.
Reimbursement Specialist Job Summary:
As a Reimbursement Specialist, you will play a crucial role in ensuring the prompt and precise processing of billing and accounts receivable responsibilities while upholding the core values and mission of our hospice organization.
Hours: Monday to Friday, 8:30 am – 5:00 pm
Location: Sarasota, FL 34238
Reimbursement Specialist Key Responsibilities:

• Promote and embody the values and mission of the hospice organization, consistently adhering to all organizational policies and procedures.
• Prepare, meticulously review, and submit monthly billings following established protocols, meticulously cross-referencing bills with census data to identify any discrepancies and ensure the correctness of patient billing revenues.
• Record all incoming payments, conduct thorough monthly reconciliations of cash receipts, and maintain detailed records and reports of accounts receivable.
• Review and rectify any errors in accounts receivable bills/records prior to transmission or mailing to ensure the accuracy of billing processes.
• Proactively address rejections, denials, and returned claims, conducting comprehensive follow-up procedures to secure payments from Medicare/Medicaid and insurance providers.
• Conduct regular billing audits to ensure adherence to regulatory requirements and maintain the precision of billing practices.
• Respond promptly and effectively to inquiries from insurance sources and Case Managers regarding patient status or obtaining updated authorizations.
• Collaborate closely with relevant departments and personnel to obtain necessary information for billing purposes, ensuring seamless coordination of patient care.
• Liaise with the Medical Records department as required to obtain vital information and records for billing purposes.
• Coordinate the compilation and submission of necessary information for Medicaid and Medicaid managed care providers, including securing any required authorizations.
• Facilitate communication with Long Term Care (LTC) facilities concerning patient responsibility and notification of Tidewell Hospice (or affiliate) Admission.
• Continuously seek opportunities to streamline processes, maintain high standards of quality, and deliver exceptional customer service.

Reimbursement Specialist Qualifications:

• Previous experience in healthcare billing, with specific expertise in Part A billing preferred.
• Proficiency in utilizing billing software/systems and Microsoft Office applications, particularly Excel.
• Strong attention to detail and a commitment to accuracy in data entry and record-keeping.
• Excellent communication skills, both verbal and written, with the ability to effectively engage with internal and external stakeholders.
• Demonstrated ability to prioritize tasks efficiently and work autonomously with minimal supervision.
• Knowledge of Medicare/Medicaid regulations and insurance billing practices is advantageous.
• Commitment to maintaining confidentiality and upholding ethical standards in all work-related activities.

Education:
High school diploma or equivalent is required.
Pay Rate:
$19-$23/HR