Reimbursement Specialist II

Alternate Solutions Health Network; Kettering (OH); Vor Ort; USD 25.000 - 36.000; Vollzeit

Zusammenfassung

Alternate Solutions Health Network is seeking a Reimbursement Specialist to manage all payment collections for assigned payors from our Kettering, OH office. The role requires ensuring prompt payments, accurate claim processing, and adherence to Medicaid, private insurance, and company policies.

The position emphasizes billing accuracy, client guidance on procedures, and teamwork to maintain patient satisfaction and quality outcomes. Office-based with a hybrid option based on productivity.

Qualifikationen

• Billing and Health Care experience is required.
• Excellent oral and written communication skills.
• Proficiency in Microsoft Excel, Word, and Outlook.
• Detail oriented with ability to manage multiple responsibilities and ability to prioritize responsibilities.

Aufgaben

• Collects and follows up on accounts for payment in full.
• Sends all electronic and paper claim resubmissions or correct claims.
• Makes recommendations regarding difficult payors with regards to prompt payments and claims processing.
• Assists clients and families in understanding billing procedures and payment.
• Corrects claims and rebills for payment.
• Communicates with employees, clients and vendors regarding services.
• Follows all legal rules and regulations.
• Attends in-services and meetings as necessary.
• Other duties as assigned.

Kenntnisse

Excellent communication

Detail oriented

Critical thinking

Problem solving

Ausbildung

High school diploma or equivalent

Associate’s degree or equivalent experience

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Jobbeschreibung

Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.

Schedule: Monday - Friday, 8:15am - 5:00pm in our office in Kettering OH

Location: In-office at our Kettering, OH location | Hybrid Model available based on productivity

The Reimbursement Specialist is responsible for all collection aspects for assigned payors and confirms eligibility for payor types. The Reimbursement Specialist ensures prompt payments and claim processing. Functions of this role performed timely and accurately, affect patient satisfaction, and quality outcomes. The Reimbursement Specialist complies with all legal, Medicaid & private insurance and company rules and regulations.

Responsibilities:

• Collects and follows up on accounts for payment in full
• Sends all electronic and paper claim resubmissions or correct claims
• Makes recommendations to the Controller regarding difficult payors with regards to prompt payments, claims processing, and recognition of denial trends.
• Assists clients, their families and co-workers in understanding billing procedures and payment
• Corrects claims and rebills for payment
• Communicates with employees, clients and vendors in regards to services
• Proactively addresses billing challenges
• Understands and practices agency policies and procedures
• Continually improves practices
• Follows all legal rules and regulations
• Attends in-services, educational programs and meetings as necessary
• Other duties as assigned

Qualifications:

• High school diploma or equivalent.
• An Associate’s degree or equivalent experience required.
• Billing and Health Care experience is required
• Excellent oral and written communication skills.
• Proficiency in Microsoft Excel, Word, and Outlook.
• Detail oriented with ability to manage multiple responsibilities and ability to prioritize responsibilities. Demonstrate critical thinking and problem solving.

Kettering, OH

#INDASHN3

This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

We are an Equal Opportunity Employer.