Reimbursement Specialist, Day Shift, Patient Financial Services
Core
Process insurance claims, resolve denials, and collect payments for patient accounts within a healthcare setting.
Role type
Reimbursement Specialist
Builds
Payment collections and claim adjudication workflows for patient financial services
Domain
Healthcare / Insurance Payer Relations
Required skills
Insurance claim adjudication, denial management, payer communication, coordination of benefits, appeals processing, root cause analysis, data verification
Preferred skills
Experience in healthcare environment, insurance company, or outsourcing
Technologies
Online payer portals, bill scrubber systems
Responsibilities
Follow up on billed and denied accounts with third-party payers, verify coordination of benefits, submit adjustment requests for uncollectable services, file appeals for denied claims, contact payers to obtain payment or commitment, route denials to appropriate teams, transfer unpaid balances to patients, review explanations of benefits, process payer changes
Seniority
Mid-level individual contributor