Sr. Contract Reimbursement Representative (H)
Core
Review and analyze medical credits, interpret contract rates, process refunds, and assess patient coverage to ensure accurate reimbursement practices for a university health system.
Role type
Contract Reimbursement Representative
Builds
Accurate reimbursement processes and financial reporting for patient care services
Domain
Healthcare administration / Medical billing
Required skills
Medical billing and collections, Contract rate interpretation, Florida Prompt Pay Law, Medicare/Medicaid/Managed Care knowledge, Patient eligibility assessment, Refund processing, Epic EHR familiarity
Preferred skills
Epic experience
Technologies
Epic
Responsibilities
Review and analyze credits within assigned WQs for proper resolution; Review and interpret contract rates to ensure proper reimbursement; Serve as a liaison between Credit Balance Unit and external departments, vendors, patients, and Third Party Companies; Review refund requests submitted by payers and patients to ensure validity; Apply Florida Statutes accordingly to commercial payers; Assess patients' coverage and eligibility, as well as pre-authorizations; Process refunds via check, credit card portal, and wire transfer; Provide ongoing in-service training for onboarding staff and vendors.
Seniority
Entry-level to Mid-level, individual contributor
