South Portland, Maine
Patient Accounts Reimbursement Specialist Job Opening in South Portland, Maine - New England Life Care (NELC) is a leading provider of home infusion therapy services and is the region?s only non-profit provider. NELC was created by local hospitals to ensure their patients have access to a provider that reflects their commitment to excellence, quality care and ethics. Like our owner hospitals, NELC provides patient focused care. To learn more about our unique, rapidly growing organization, please visit our website at .
We currently have an opportunity for a full time Reimbursement Specialist . Reporting to the Manager of Billing and Collections, the person in this position is responsible for the timely and accurate billing of insurances including billing documentation and resolving denied / suspended claims.
Responsibilities :
Assures that all patient charges are accurate & in compliance with payer contracts; edits invoices (claims) as needed to insure accuracy.
Demonstrates clear understanding of billing documentation requirements for all payers.
Ensures that all claims are processed within expected timeframes ensuring that required supporting clinical documentation & Authorizations are on file prior to processing.
Evaluates and works to resolve denied/suspended claims for claims submitted to Medicare
Utilizes websites, memos and other resources to stay current with all payer policy or procedure changes
Maintains & requests To do?s for authorizations and re-bills.
Maintains current knowledge of all payer contract updates. Identifies potential billing concerns as new or amended contracts are implemented
Qualifications:
High school diploma or equivalent required. Associated degree preferred.
2 years experience in a healthcare setting processing claims or comparative experience
Knowledge of health insurance plan benefits and rules / regulations for obtaining reimbursement
Experience with healthcare patient account / billing / collections computer applications including electronic claims processing
Excellent customer service, communication and organization skills
Knowledge of medical terminology: CPT, ICD9, HCPC required
Benefits:
Medical, Dental, Vision
Life Insurance
Short / long term disability
403B Retirement plan with company match
PTO plan and paid Holidays
Job Type: Full-time
Required education:
High school or equivalent
Required experience:
Medical Billing: 1 year
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