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Reimbursement Specialist

Company: Change Healthcare
Location: Madison
Posted on: January 16, 2022

Job Description:

Overview of Position The Reimbursement Specialist will follow up and pursuit of unpaid hospital insurance accounts. Possess proficiency in all aspects of facility hospital claims, insurance collections follow up including billing, coding, contracts and reimbursement to pursue underpaid variances and denials. Subsequent verbal resolution push and/or submission of written payer disputes/appeals of underpaid accounts and denials, as well as corrected claim submission. Provide complete and thorough account reviews and audit documentation, as well as perform appropriate action steps to pursue payments for account resolution. What will be my duties and responsibilities in this job? + Excellent knowledge of insurance industry process and procedures+ Strong decision making, and problem-solving skills are needed, as well as an ability to work independently with minimal supervision.+ Understanding and knowledge of CPT-4/HCPC/DRG/ICD/HCPCs, and Revenue codes+ Enhanced knowledge of HIPAA privacy guidelines as well as maintaining and protecting all confidential information.+ Ability to multitask and set priorities on multiple projects for the highest rate of returns.+ Knowledge of Commercial, Medicare/Medicaid and Medicare/Medicaid HMO's+ Understanding of A/R projects procedures and process, and the follow up required to drive collections+ Sorting and filtering in Excel skills requiredWhat are the requirements needed for this position?+ High school diploma or GED required + Prior experience in hospital revenue cycle billing, follow-up and reimbursement. + Requires at least 2 years prior experience in the healthcare field, specific to understanding the drivers causing hospital claim non-payment and denials, and the follow up dispute resolution processes required by the various insurance carriers/payers to overturn and generate reimbursement. What other skills/experience would be helpful to have?+ Possess and apply a thorough knowledge of pursuit of insurance hospital payments.+ Note and document accounts appropriately+ Request or bill corrected claims as needed+ Review hospital/provider notes, payments, refunds, recoups, and articulate underpayment causes and denials with payers+ Review variances and take appropriate action to engage the payers to render payment+ Request and review additional hospital information as appropriate+ Learn, comprehend and navigate complex hospital systems+ Follow HIPAA guidelines in handling patient information+ Prioritize workloads using tools and resources in the most efficient manner to produce highest levels of quality productivity leading to appropriate account resolution.What are the working conditions and physical requirements of this job? General office duties and conditions Must have acute hospital experience with Medicare. Must be proficient with FISS, DDE system and knowledge of Medicare billing and compliance guidelines Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system! COVID MandateAs a federal contractor, Change Healthcare is adhering to the Executive Order which mandates vaccination. As such, we are requiring all U.S. new hires and employees to show proof of being fully vaccinated for COVID-19 or receive an approved accommodation by their date of hire, as a condition of employment. As we continue to navigate the ever-changing COVID-19 pandemic, we remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. Proof of vaccination or accommodations requests will be collected once an offer is accepted with Change Healthcare. All accommodation requests will be carefully considered but are not guaranteed to be approved. Equal Opportunity/Affirmative Action Statement Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at and the supplemental information at\_EEO\_Supplement\_Final\_JRF\_QA\_508c.pdf.If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.Click here\_%20English\_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy. California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare's Privacy Notice to California Job Applicants Regarding the Collection of Personal Information ( . Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.

Keywords: Change Healthcare, Madison , Reimbursement Specialist, Other , Madison, Wisconsin

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