Reimbursement, Team Lead

U.S. Renal Care is seeking a Reimbursement Representative for our dialysis facilities. The Reimbursement Representatives role is to file insurance claims and collect on accounts assigned in a timely and accurate manner.ESSENTIAL DUTIES AND RESPONSIBILITIES include the following: Reviews EOB/EOMB''s for proper reimbursement. Responsible for all collection activities on identified accounts. Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner. Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment. Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed. Provides insurance carriers with requested information to facilitate payment. Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits. Performs claim appeals as required. Assists with credit balance resolution. Completes re-bill request as necessary to facilitate timely and proper claims payment. Follows up on unresolved account balances including RTP''s. Prepares adjustment and write-off requests as necessary. Performs other duties and responsibilities as required or assigned. Monitors all contracts and single patient agreements to ensure that appropriate reimbursement is received. EDUCATION and/or EXPERIENCE: High School diploma or GED required. Minimum of two years experience in health/medical billing and collections.U.S. Renal Care is an Equal Opportunity Employer/Disabled/Veteran Additional Information

Created: 2021-11-29