Reimbursement Specialist

AdvancedMD is hiring a Reimbursement Specialist. Reimbursement Specialists on the Premier Specialty Team focused Team offer insightful expertise as it relates to their assigned client base. The associates on this team are assigned to one of three functional areas, Claim Management, Denial Management and Aged Unpaid Claim Follow up. These team members work directly with clients to identify, prioritize and manage strategic needs for an efficient service workflow for optimal A/R outcomes. Reimbursement Specialists will manage a broad array of projects in relation to claims resolution, including payer tracking, website access, claims status inquiries, and direct carrier contact.

At AdvancedMD we are driven by your success. We engage your unique talents and perspectives. We welcome your ideas on how to do things differently and better. In your efforts to achieve, learn and grow, we support you all the way. If success motivates you, you belong at AdvancedMD.

Integrity is Everything is a core value at AdvancedMD. Medical practitioners across the country turn to AdvancedMD for fully integrated Electronic Health Record (EHR) and Practice Management solutions they can trust. We are one of the nation's largest providers of cloud medical practice optimization software and a leader in cloud electronic health record (EHR), practice management, medical scheduling software, and billing applications for medical practices and medical billing services.

Client support at AdvancedMD. It's all about enabling the clients we serve to be more effective employers. You make it happen by collaborating with other AdvancedMD Associates to ensure our products and services deliver winning results. You provide the expert support that makes our workforce solutions stand out in an increasingly competitive global marketplace.

We strive for every interaction to be driven by our CORE values: Insightful Expertise, Integrity is Everything, Service Excellence, Inspiring Innovation, Each Person Counts, Results-Driven, & Social Responsibility.

RESPONSIBILITIES:

• Correct Claims pre-submission for identified edits that will result in a claim denial or delay.
• Follow up on Denied Claims as identified through carrier denials.
• Follow up on Unpaid Claims in an aged approach for final claim resolution.
• Communicate and manage internal and external requirements and expectation.
• Proactively build client specific claim edits to avoid future claim denials.
• Assure client satisfaction
• Communicate proactively with clients to avoid escalation
• Track A/R progress and profitability of client accounts
• Identify and analyze reimbursement trends within the client they are working.
• Identify any issues or problems with payers as the possible difficulties in presenting clean claims to them based upon their submission requirements
• Identify payer trends

QUALIFICATIONS REQUIRED:

• 3-5 years of medical billing experience with a minimum of 1 years in at least one of the following specialties required:
• Dermatology
• Pediatric
• Otolaryngology
• Pulmonary
• Cardiology
• OBGYN
• Gastroenterology
• Otolaryngology
• Rheumatology
• Orthopedic

PREFERRED QUALIFICATIONS: Preference will be given to candidates who have the following:

• Knowledge of Medicare, Medicaid and commercial payors claims and appeals processing requirements a must.
• Knowledge of ICD, CPT and HCPC coding, ability to ready EOB and ERA files.
• Deep understanding of CCI edits and carrier specific coding edits for the above mentioned specialties.
• Strong working knowledge of Windows, MS Word, Internet Explorer, Excel, Powerpoint.
• Must have a deep understanding of the Medical Billing Process and Industry Standard
• Ability to manage and fulfill client expectations
• Excellent written and oral communications skills
• Proven track record or writing compelling appeals with favorable outcomes
• Excellent communication and organizational skills with a customer service focus
• Ability to prioritize effectively and handle shifting priorities professionally
• Knowledge of medical computerized billing and scheduling software systems
• Personal track record of being thorough, courteous and responsive in customer service
• Ability to communicate with various business contacts in a professional and courteous manner self-starter, with the ability to organize work for maximum efficiency and attention to quality
• Proven ability to meet deadlines in a fast-paced environment
• Ability to grasp new concepts and procedures quickly, with a desire to learn.

Job Type: Full-time

Pay: $17.00 - $19.00 per hour

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Disability insurance
• Flexible schedule
• Flexible spending account
• Health insurance
• Life insurance
• Paid time off
• Tuition reimbursement
• Vision insurance

Schedule:

• Monday to Friday

Education:

• High school or equivalent (Required)

Experience:

• Claims: 2 years (Required)
• Medical Billing: 1 year (Preferred)

Work Location:

• One location

Company's website:

• https://www.advancedmd.com/

Benefit Conditions:

• Only full-time employees eligible

Work Remotely:

• Temporarily due to COVID-19

COVID-19 Precaution(s):

• Remote interview process