Reimbursement Specialist

Medical Service Company; Toledo (OH); Hybrid; USD 55,000 - 70,000; Full time

Benefits offered by this job

Competitive Pay

Advancement Opportunities

Medical, Dental & Vision Insurance

HSA with Company Contribution

Pet Insurance

Life and AD&D Insurance

Disability Insurance

Tuition Reimbursement

EAP

Job summary

MSC, a Medical Service Company, is seeking a Reimbursement Specialist for a full-time hybrid role. The position entails timely billing and collections for Medicare, Medicaid, and commercial insurance carriers, with in-office days Tue–Thu and remote work on other days.

Responsibilities include reviewing rejected claims, following up on denials, maintaining detailed notes, and assisting internal departments with billing issues.

Qualifications

• Minimum of three years of progressive third-party payor reimbursement experience in healthcare.
• Strong knowledge of Medicare, Medicaid and commercial insurance guidelines, procedures, and rules for HME billing.
• Experience with escalating billing disputes, including appeals, reviews, and redeterminations.
• Excellent communication and customer relations skills.
• Excellent interpersonal and organizational skills (a team player).
• Brightree experience preferred; standard office/computer skills.

Responsibilities

• Review rejected claims from the clearinghouse and front-end payor edits; follow up on unprocessed claims; research denials for resubmission to maximize reimbursement.
• Maintain accurate notes on each invoice worked.
• Respond to patient inquiries by phone, email, or from other internal departments.
• Assist internal departments with billing-related issues.
• Communicate obstacles to Billing Manager that may lead to inaccurate or untimely resubmission of claims.
• Performs other duties as assigned.

Skills

Third-party payor experience

Medicare/Medicaid knowledge

Billing disputes & appeals

Communication skills

Interpersonal skills

Brightree experience

Education

High school diploma or GED

Tools

Brightree

Job description

At MSC, we are dedicated to enhancing patient comfort and quality of life with over 75 years of experience and accredited by the Accreditation Commission for Health Care (ACHC).MSC is a 13 -Time recipient of the prestigious NorthCoast 99 Award as a Top Workplace to work!MSC is a two-time recipient of the prestigious National HME Excellence Award for Best Home Medical Equipment company in the US.In addition, MSC is very proud to announce its debut on the Inc. 5000 list in 2024, marking a significant milestone in our company's growth and success!Join Our Team!We are excited to announce that we are hiring for a full-time hybrid position. Work in our office location on Tuesdays, Wednesdays, and Thursdays, and enjoy the flexibility of remote work on other days. Benefits included!

• Competitive Pay


• Advancement Opportunities


• Medical, Dental & Vision Insurance


• HSA Account w/Company Contribution


• Pet Insurance


• Company provided Life and AD&D insurance


• Short-Term and Long-Term Disability


• Tuition Reimbursement Program


• Employee Assistance Program (EAP)


• Employee Referral Bonus Program


• Social Recognition Program


• Employee Engagement Opportunities


• CALM App


• 401k (with a matching program) / Roth IRA


• Company Discounts


• Payactiv/On-Demand Pay


• Paid vacation, Sick Days, YOU (Mental Health) Days and Holidays

Reimbursement Specialists are responsible for the timely and accurate billing and collections for Medicare, Medicaid, and Commercial insurance carriers.

Responsibilities and Duties

• Conducts review of rejected claims from the clearinghouse and front-end payor edits, follows up on unprocessed claims, and researches denials for resubmission to ensure timely collection and maximum reimbursement.


• Maintains accurate and complete notes on each invoice worked.


• Responds to patient inquiries received via phone, email, or from other internal departments.


• Assists internal departments and staff with billing related issues.


• Communicates obstacles or challenges to Billing Manager that may lead to inaccurate or untimely resubmission of claims.


• Performs other duties as assigned.

Qualifications

Education: Graduate of an accredited high school or GED equivalent.

Experience/Knowledge/Skills/Physical Requirements

• Minimum of three years of progressively responsible third-party payor reimbursement experience in healthcare.


• Strong knowledge of Medicare, Medicaid and commercial insurance guidelines, procedures, and rules and regulations for HME billing.


• Experience with escalating billing disputes, including appeals, reviews, and redeterminations.


• Excellent communication and customer relation skills.


• Excellent interpersonal and organizational skills (a team player).


• Normal office/clerical motor skills in addition to extensive computer and telephone experience. Brightree experience preferred.