WellSky · 14 hours ago

Reimbursement Coordinator - HMO Billing, SNF

United States

Full-time

Remote

Entry Level

1+ years exp

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Health CareSoftware

No H1B

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Responsibilities

Obtaining billing information from clients to generate claims

Performing QA of charges received and making modifications/changes to product a clean claim

Tracking pending claims

Submitting claims to insurance companies in a timely fashion and within the individual insurance company’s timely filing period

Obtaining claim status by calling the payer and/or using an online claims status system

Researching claim payments, partial payments, over payments

Focusing on all denied/partially paid claims until full payment is received

Working in a time-efficient manner to cover all denied claim from assigned homes

Knowing when to forward a case to the biller/tracker

Understanding how the higher dollar balances impact our collection rate and focus

Prioritizing the “clean up” of balances by writing off rates/NAMI's/other adjustments

Qualification

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Claim researchBilling information managementClaims submissionMicrosoft OfficeDeadline orientationPerseveranceQA of chargesClaim status trackingDenial management