Managed Care Reimbursement Specialist (Onsite)

Bronson Health; Portage (MI); On-site; USD 30,000 - 39,000; Full time

Job summary

Bronson Health in Portage, MI is seeking a Reimbursement Specialist for onsite work in the Comm/Mgd Care area. You will help ensure accurate third-party billing, post payments, and manage payer communications to maximize reimbursement.

Responsibilities include analyzing CPT-4, ICD-10 codes, UB04/HCFA 1500 forms, resolving denials, and maintaining HIPAA compliance across multiple entities. Strong EPIC experience and communication skills are required.

Qualifications

• High school diploma or GED required.
• Associate's degree in business or Finance; or equivalent experience in Medical Billing, Receivables or Collection preferred.
• Successfully pass EUPA's for all Epic applications associated with position within the first 90 days in the position.
• Strong computer and general office equipment knowledge required.
• Knowledge of medical terminology, ICD-10 and CPT-4 coding, National Billing forms, third-party payers, managed care, reimbursement and regulatory compliance preferred.
• Ability to type 45 words per minute is necessary.
• Must be an effective communicator with patients, customers and co-workers.
• Must be able to quickly analyze communication style based on nature and approach of verbal inquiry.

Responsibilities

• Analyze CPT-4, ICD-10, UB04, HCFA 1500 and charges for accuracy to maximize reimbursement.
• Postings, adjustments and refunds to accounts and critique contractual allowances.
• Resolve billing issues up front to promote better reimbursement and reduce denials.
• Ensure claims are compliant with payer specifications; State, Federal and HIPAA regulations.
• Proficient in revenue cycle processes using multiple systems (EPIC, STAR, EC2000, SSI, GLMI).
• Verify insurance eligibility using automated on-line systems.

Skills

Medical billing

Accounts receivable

HIPAA compliance

ICD-10 coding

CPT-4 coding

Epic

Education

Associate's degree in business

Finance

Tools

EPIC

STAR

EC2000

Job description

Bronson Health in Portage, MI is seeking a Reimbursement Specialist for onsite work in the Comm/Mgd Care area. You will help ensure accurate third-party billing, post payments, and manage payer communications to maximize reimbursement.

Responsibilities include analyzing CPT-4, ICD-10 codes, UB04/HCFA 1500 forms, resolving denials, and maintaining HIPAA compliance across multiple entities. Strong EPIC experience and communication skills are required.