Bronson Healthcare ยท 11 hours ago
Reimbursement Specialist (Osite)
Greater Kalamazoo Area
Full-time
Onsite
New Grad, Entry LevelBronson Healthcare is a compassionate and resilient organization dedicated to providing exceptional care for patients and the community. The Reimbursement Specialist role involves facilitating payment from third-party payers, ensuring compliance with regulations, and resolving billing issues to maximize reimbursement.
Health CareHospitalMedicalNon ProfitPrimary and Urgent Care
Responsibilities
Performs duties necessary to facilitate payment from third party payers
This includes correct billing, statusing and collection from third parties, posting third party payments (if applicable), computing correct reimbursement, processing incoming and outgoing correspondence, and maintaining a working knowledge of current contracts and government regulations for multiple entities
Accountable for ensuring claims are compliant with all payer specifications; State, Federal and HIPAA regulations
Resolves billing issues up front to promote better reimbursement, reduce outstanding revenue and time spent on working rejections or additional claim follow up
Prepares documentation to maximize reimbursement
Analyze assignment of all CPT-4, ICD-9, UB04, HCFA 1500 and charges for accuracy and to maximize reimbursement from third party payers
Critically analyze and process third party and internal information requests and rejections in an effort to resolve accounts receivable
Critically analyze and process documents for resolution of third party liabilities, outstanding credits and un-billed accounts
Make all necessary posting, adjustments and refunds to accounts and critique contractual allowances and other arrangements
Responsible for complete understanding and application of current contracts and governmental regulations including referrals for legal intervention for multiple entities
Proficient in the revenue cycle process via multiple computer systems including but not limited to: Internal systems: STAR, EC2000, EPIC, SSI, GLMI Home Health Billing system and External systems such as payer claims and eligibility systems
Verifies insurance eligibility using automated on-line systems
Qualification
Required
High school diploma or general education degree (GED) required
Successfully pass EUPA's for all Epic applications associated with position within the first 90 days in the position
Strong computer and general office equipment knowledge required
Ability to type 45 words per minute is necessary
Must be an effective communicator with patients, customers and co-workers
Must be able to quickly analyze communication style based on nature and approach of verbal inquiry
Accountable for ensuring claims are compliant with all payer specifications; State, Federal and HIPAA regulations
Resolves billing issues up front to promote better reimbursement, reduce outstanding revenue and time spent on working rejections or additional claim follow up
Prepares documentation to maximize reimbursement
Analyze assignment of all CPT-4, ICD-9, UB04, HCFA 1500 and charges for accuracy and to maximize reimbursement from third party payers
Critically analyze and process third party and internal information requests and rejections in an effort to resolve accounts receivable
Critically analyze and process documents for resolution of third party liabilities, outstanding credits and un-billed accounts
Make all necessary posting, adjustments and refunds to accounts and critique contractual allowances and other arrangements
Responsible for complete understanding and application of current contracts and governmental regulations including referrals for legal intervention for multiple entities
Proficient in the revenue cycle process via multiple computer systems including but not limited to: Internal systems: STAR, EC2000, EPIC, SSI, GLMI Home Health Billing system and External systems such as payer claims and eligibility systems
Verifies insurance eligibility using automated on-line systems
Preferred
Associate's degree in business or Finance; or equivalent experience in Medical Billing, Receivables or Collection preferred
Knowledge of medical terminology, ICD-9 and CPT-4 coding, National Billing forms, third-party payers, managed care, reimbursement and regulatory compliance preferred
Company
Bronson Healthcare
Bronson Healthcare is a not-for-profit, group healthcare organization that provides services ranging from primary care and emergency care.
Founded in 1900
5001-10000 employees
Funding
Current Stage
Late StageLeadership Team
Bill Manns
President & Chief Executive Officer
Recent News
2025-10-27
2025-10-20
Company data provided by crunchbase