Reimbursement Specialist - Medical Billing & Claims

U.S. Renal Care; Plano (TX); On-site; USD 42,000 - 66,000; Full time

Benefits offered by this job

Medical / Pharmacy

Dental

Vision

Voluntary benefits

401k with employer match

Virtual Care

Life Insurance

PTO

Job summary

U.S. Renal Care in Plano, Texas, is seeking a Reimbursement Representative to join our billing team. You will reconcile Medicare/Commercial balances, review EOBs, and pursue timely reimbursement according to policy.

The role requires accuracy, knowledge of CPT/ ICD-9/HCPCS, and familiarity with HIPAA. You will communicate with payors, perform appeals, and support credit balance resolution.

Qualifications

• High School diploma or GED required.
• At least two years of experience in health/medical billing and collection.
• Proficient with computers and medical billing software.
• Advanced knowledge of CPT, ICD-9 and HCPCS coding.
• Strong knowledge of government and private insurer rules and regulations.
• Working knowledge of Microsoft Outlook, Word and Excel.

Responsibilities

• Reviews EOB/EOMB's for proper reimbursement.
• Resolves electronic claim rejections and EOB denials promptly.
• Reviews and researches insurance correspondence and makes corrections to ensure claims payment.
• Follow up on unpaid balances and work AR aging reports as directed.
• Regularly contacts Medicare, Medicaid and Commercial payors for resolution.
• Performs claim appeals as required.
• Assists with credit balance resolution.
• Completes re-bill requests to facilitate timely payments.
• Follow up on unresolved balances including RTPs.
• Prepares adjustment and write-off requests as necessary.
• Performs other duties as required.

Skills

Medical terminology

HIPAA compliance

Microsoft Outlook

Excel

Education

High School diploma or GED

Tools

Medical billing software

Job description

U.S. Renal Care in Plano, Texas, is seeking a Reimbursement Representative to join our billing team. You will reconcile Medicare/Commercial balances, review EOBs, and pursue timely reimbursement according to policy.

The role requires accuracy, knowledge of CPT/ ICD-9/HCPCS, and familiarity with HIPAA. You will communicate with payors, perform appeals, and support credit balance resolution.