Reimbursement Specialist

County-of-Lapeer; Mayfield Township (MI); On-site; USD 38,000 - 52,000; Full time

Job summary

Lapeer County Community Mental Health is seeking a Reimbursement Specialist to perform accounting-related reimbursement and billing tasks. The role reports to the Accounting/Billing Supervisor and handles posting of third-party payments, resubmission of rejected billings, and assisting with enrollment forms and prior authorizations.

Responsibilities include ATP determinations, generating staff/reporter reports, maintaining EMR rate schedules, and supporting Accounts Payable and Claims

Qualifications

• High school diploma or equivalent.
• One year experience in a related environment.
• Proficiency with Microsoft Office suite; especially Word, Excel, Outlook, Access.
• Billing or accounting experience preferred.

Responsibilities

• Posts third party and other billing payments received.
• Follows up and resubmits rejected and pended third party billings.
• Assists in completion of provider enrollment forms for public and private insurances.
• Assist in obtaining prior authorizations.
• Gathers initial demographic and financial information to conduct ability to pay (ATP) determinations.
• Provides and reviews annual ATP redeterminations.
• Assist in generating payment plans for delinquent accounts.
• Generate reports for staff or providers as needed.
• Participates in agency committees as directed.
• Entry and maintenance of direct run locations.
• Maintain and update rate schedules as needed in EMR.
• Provide support to Accounts Payable, Claim Adjudication, and CCBHC Specialists as necessary.

Skills

Billing

Accounting

Microsoft Word

Microsoft Excel

Microsoft Outlook

Microsoft Access

Education

High School Diploma or Equivalent

Advanced coursework in accounting or computer skills

Job description

General Summary:The Reimbursement Specialist performs a variety of accounting-related functions related to reimbursement, and billing.Position reports to: Accounting/Billing SupervisorEssential Functions:Posts third party and other billing payments received.Follows up and resubmits rejected and pended third party billings.Assists in completion of provider enrollment forms for public and private insurances.Assist in obtaining prior authorizations.Gathers initial demographic and financial information to conduct ability to pay (ATP) determinations.Provides and reviews annual ability to pay redeterminations.Assist in generating payment plans for delinquent accounts.Generate reports for staff or providers as needed.Participates in agency committees as directed.Other Functions:Entry and maintenance of direct run locations.Maintain and update rate schedules as needed in EMR.Provide support to Accounts Payable, Claim Adjudication, and CCBHC Specialists as necessary.Other duties as assigned in a positive, cooperative mannerLapeer County Community Mental Health embraces an employment environment that promotes recovery and discovery, a person-centered approach to treatment/services, and cultural competence. An employee with this or any position is expected to support the employment environment.Employment QualificationsEducation: High school graduation or equivalent. Advanced course work in accounting or computer skills preferred.Experience:One year experience working in a related environment.Knowledge and experience in Microsoft environment (Word, Excel, Outlook, Access)Prefer experience and training in billing or accounting related services.