Cardiology Specialists of Acadiana is seeking a medical Reimbursement Specialist.
Achieves maximum revenue collections
from insurances and patients through timely entry, filing and follow-up;
maintains thorough and accurate transaction and correspondence on patient
accounts; provides insurance claims education to patients; posts payments &
adjustments; reconciles batches and accounts
thorough understanding of all medical insurance terminology, ICD-10 coding,
CPT-4 coding, remittance advices and explanation of benefit forms.
health insurance guidelines, esp Medicare, Medicaid, HMOs, PPOs
how to post a remittance advice or explanation of benefits, electronically or
primary and secondary claims timely.
and posts insurance & patient payments and adjustments correctly in
accordance with policy and procedure and assigned timeframe.
accounts of assigned alphabet are managed timely for outstanding insurance, denials,
filed rejected, appeals for payment within 30 days
on unresolved claims no less than every 30 days.
documents tasks performed on each patient account in EMR.
patient collections on overdue accounts.
and enters charges with correct diagnoses and modifiers within 48 hrs of charge
availability in billing module; prepares clean and timely claim for insurance
patients in a friendly and professional manner, whether in person or via
telephone, determines their needs and responds accordingly; educates patients
on insurance as needed.
and/or reviews current & accurate demographic and insurance data relative
to dates of service, including insurance cards into patient registration
medical insurance coverage and documents benefits information as needed.
EMR and PM system accurately.
any other services deemed reasonable by physician or supervisor.
Experience: High school diploma or equivalent. A
minimum of one year’s experience in a medical office or other healthcare
setting. Certification and/or experience in reimbursement preferred.