Reimbursement Specialist II

Alternate Solutions Health Network; Kettering (OH); Hybrid; USD 42,000 - 64,000; Full time

Job summary

Alternate Solutions Health Network in Kettering, OH is seeking a Reimbursement Specialist. In-office role with hybrid model based on productivity, Monday–Friday, 8:15am–5:00pm.

You will manage collections, verify eligibility, and ensure timely payments while maintaining compliance with Medicaid and private insurance regulations. Strong Excel/Word/Outlook skills and attention to detail are essential for success.

Qualifications

• High school diploma or equivalent required.
• An Associate’s degree or equivalent experience preferred.
• Billing and healthcare experience required.
• Excellent oral and written communication skills.
• Proficiency with Microsoft Excel, Word, and Outlook.
• Detail-oriented with ability to manage multiple responsibilities.

Responsibilities

• Collects and follows up on accounts for payment.
• Sends electronic and paper claim resubmissions or correct claims.
• Makes recommendations regarding difficult payors with regards to prompt payments and processing.
• Assists patients, families and coworkers in understanding billing procedures.
• Corrects claims and rebills for payment.
• Communicates with employees, clients and vendors regarding services.
• Adheres to Medicaid, private insurance and company policies.

Skills

Billing experience

Health care experience

Excel

Word

Outlook

Communication skills

Attention to detail

Multitasking

Critical thinking

Education

High school diploma or equivalent

Associate’s degree or equivalent experience

Tools

Microsoft Excel

Microsoft Word

Microsoft Outlook

Job description

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 OHLocation: In-office at our Kettering, OH location | Hybrid Model available based on productivityThe 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 assignedQualifications:• 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#INDASHN3We’ll help you put your passion for patient care to work. Apply today!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.