Payer Reimbursement Specialist

101 Rogers Memorial Hospital, Inc.; Town of Oconomowoc (WI); On-site; USD 48,000 - 64,000; Full time

Benefits offered by this job

Health, dental, and vision insurance

401(k) retirement plan

Employee share program

Life/disability insurance

Flexible spending accounts

Tuition reimbursement

Health and wellness program

Employee assistance program

Job summary

Rogers Behavioral Health, Inc. in Wisconsin seeks a Reimbursement Specialist to support timely billing and accurate reimbursement across commercial and government payers.

The role involves collaborating with departments to drive payer collections and communicating process improvements to leadership. Ideal candidates will have 3+ years in medical billing/collections, knowledge of UB04/HCFA 1500, and strong analytical and communication skills to educate and support the team while ensuring

Qualifications

• 3+ years in mental health or medical insurance billing and/or collections.
• Experience with UB04 and HCFA 1500 billing.
• Knowledge of third-party payer guidelines and reimbursement processes.
• Strong communication and organizational skills.

Responsibilities

• Identify underpayments and analyze discrepancies for denials and appeals.
• Examine claims to ensure payer contract compliance.
• Review posted payments for accuracy.
• Analyze explanations of benefits for proper reimbursement.
• Follow up with payers on outstanding claims and resolve variances.
• Monitor denial reason codes and root causes.
• Collaboration with payer contracting to resolve issues.
• Track collection trends and provide improvement ideas.

Skills

Communication skills

Analytical thinking

Customer service

Multitasking

Team collaboration

Education

High school diploma or equivalent

Associate or Bachelor's degree preferred

3+ years in medical billing/collections

Tools

Microsoft Word

Excel

Outlook

Teams

OneNote

Oracle Health Patient Accounting

Job description

Rogers Behavioral Health, Inc. in Wisconsin seeks a Reimbursement Specialist to support timely billing and accurate reimbursement across commercial and government payers.

The role involves collaborating with departments to drive payer collections and communicating process improvements to leadership. Ideal candidates will have 3+ years in medical billing/collections, knowledge of UB04/HCFA 1500, and strong analytical and communication skills to educate and support the team while ensuring