Reimbursement Specialist - Must be Local (3784)

Mary Rutan Health; Bellefontaine (OH); Hybrid; USD 55,000 - 75,000; Full time

Job summary

Mary Rutan Health is seeking a Medical Reimbursement Specialist to provide central routing and resolution of underpayments and overpayments for the hospital and clinics in Bellefontaine, OH. The role collaborates with Patient Financial Services and payors to ensure accurate payments and compliance with contracts.

Option to work from home is available for non-probationary staff with network requirements; occasional on-site attendance may be required weekly.

Qualifications

• High School diploma or GED is required.
• At least 3 years of healthcare Revenue Cycle experience, preferably focused on reimbursement.
• Prior EMR experience is required.
• Experience with multiple cross-functional departments and/or outsource vendors is preferred. Meditech EMR strongly preferred.

Responsibilities

• Provide central routing and resolution for underpayments and overpayments.
• Collaborate with Patient Financial Services and payors to ensure payments are investigated and accurate.
• Review and process payor recoupment requests and related actions.
• Ensure compliance with contracting and hospital/clinic financial policies.

Skills

Revenue Cycle knowledge

Payor reimbursement understanding

Communication skills

Customer service orientation

Multitasking

Interpersonal skills

Problem solving

Education

High School diploma or GED

Tools

Meditech EMR

Microsoft Outlook

Microsoft Excel

Job description

Job Details: Job Location: Mary Rutan Crossroads Center - Bellefontaine, OH 43311, Position Type: Full-Time, Job Shift: Day (1st Shift), Job Summary -

The Medical Reimbursement Specialist provides central routing and further resolution related to underpayment and overpayment functions for Mary Rutan Hospital and Clinics. Functions under the responsibility of the Manager of Reimbursement Management include working with Patient Financial Services team members as well as healthcare insurance agencies in order to ensure that all payments for hospital and physician services have been investigated appropriately, claims paid accurately as per contracting, resolve underpayments, review and process payor recoupment requests accordingly, as well as other responsibilities as assigned. This role does provide the option to work from home as long as the employee is not on probation and can comply with necessary network requirements. Once approved to work remotely, there may be a requirement to be onsite once per week to tend to any responsibilities that cannot be completed remotely. This position reports to the Manager of Reimbursement Management.

Regulatory Requirements

• MINIMUM EDUCATION REQUIRED: High School graduate or GED.


• MINIMUM EXPERIENCE REQUIRED: At least three (3) years of related healthcare Revenue Cycle experience, preferably with a focus on reimbursement. Prior EMR experience of some type required.


• ADDITIONAL PREFERRED QUALIFICATIONS: At least four (4) years of previous related healthcare Revenue Cycle experience, preferably with a focus in underpayments and payor recoupment process. Demonstrated expertise working with multiple cross-functional departments and/or outsource vendors is also preferred. Experience with Meditech EMR strongly preferred.


• Employee will be required to complete a work from home agreement.

Language Skills

• Ability to communicate in English, both verbally and in writing.


• Additional languages preferred.


• Excellent interpersonal skills.

Skills

• Clear understanding of the impact payment applications, refund/credit processing, as well as underpayments has on Revenue Cycle operations and financial performance.


• Working knowledge of payor reimbursement methods (percentage of charge, fee schedule, etc.) and strong knowledge of payor payment dispute processes and methodologies


• Excellent written and verbal communication and interpersonal skills.


• Ability to prioritize and manage multiple tasks simultaneously, and to effectively anticipate and respond to issues as needed in a dynamic work environment.


• Dedication to treating both internal and external constituents as clients and customers, maintaining a flexible customer service approach and orientation that emphasizes service satisfaction and quality.


• A demonstrated ability to use PC based office productivity tools (e.g. Microsoft Outlook, Microsoft Excel) as necessary; general computer skills necessary to work effectively in an office environment.