BayCare Clinic · 11 hours ago
Reimbursement Specialist - Corporate Headquarters
Green Bay, WI
Full-time
Onsite
Mid Level
3+ years expBayCare Clinic is a physician-owned organization dedicated to providing superior specialty medical services. They are seeking a detail-oriented Reimbursement Specialist to ensure accurate and timely reimbursement for services, collaborating with management and payers to resolve discrepancies and manage reports.
Health CareHospitalMedical
Responsibilities
Conducting detailed audits in accordance with BayCare reimbursement contracts
Work collaboratively with management to review, clarify, and resolve contract discrepancies identified within EPIC
Communicating with payers via websites, phone, and written correspondence
Managing reports, follow‑ups, and status updates
Owning the details of assigned projects
Staying current with payer requirements and reimbursement contracts
Making outbound calls to challenge payments or request reconsiderations
Identifying problematic payer patterns and escalating concerns promptly
Analyze and perform complex account level reviews
Understanding and applying payer policies on paid claims
Compare contracted reimbursement rates with posted claim data to identify underpayments or fee schedule discrepancies
Maintaining confidentiality and adhering to ethical, compliant work practices
Qualification
Required
High school diploma or equivalent required
Working knowledge of medical terminology and health insurance
Strong computer skills
Strong organizational skills and attention to detail
3+ years regarding a solid understanding of healthcare billing process, insurance contracting, and the revenue cycle
Preferred
Experience with EPIC
Benefits
Health, dental, disability, and life insurance
Flexible spending options
401(k) with company match
Generous PTO and paid holidays
Company
BayCare Clinic
BayCare Clinic offers anesthesia, cardiology, vascular surgery, sports medicine, neuropsychology, radiology, and orthopedics services.
501-1000 employees
Funding
Current Stage
Late StageLeadership Team
Ashwani Bhatia. MD,CPE,FACP
Chief Executive Officer
Julie Duckett
Chief Financial Officer
Recent News
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Green Bay Press-Gazette
2024-05-04
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