Revenue Cycle Reimbursement Specialist

Bronson Methodist Hospital; Schoolcraft Township (MI); On-site; USD 42,000 - 64,000; Full time

Job summary

Bronson Methodist Hospital in Portage, MI is seeking a Reimbursement Specialist to ensure compliant billing and maximize reimbursement from third-party payers. You will handle billing, posting payments, and analyze CPT-4/ICD-10 to optimize revenue, while staying current with contracts and government regulations.

The role requires strong communication, typing speed, and knowledge of medical terminology, with experience in Epic or related billing systems.

Qualifications

• High school diploma or general education degree (GED) required.
• Associate's degree in business or Finance; or equivalent experience in Medical Billing, Receivables or Collection preferred.
• Successfully pass EUPA's for all Epic applications associated with position within the first 90 days in the position.
• Strong computer and general office equipment knowledge required.
• Knowledge of medical terminology, ICD-10 and CPT-4 coding, National Billing forms, third-party payers, managed care, reimbursement and regulatory compliance preferred.
• Ability to type 45 words per minute is necessary.
• Must be an effective communicator with patients, customers and co-workers.
• Must be able to quickly analyze communication style based on nature and approach of verbal inquiry.

Responsibilities

• Accountable for ensuring claims are compliant with all payer specifications; State, Federal and HIPAA regulations.
• Resolves billing issues up front to promote better reimbursement, reduce outstanding revenue and time spent on working rejections or additional claim follow up.
• Prepares documentation to maximize reimbursement.
• Analyze assignment of all CPT-4, ICD-10, UB04, HCFA 1500 and charges for accuracy and to maximize reimbursement from third party payers.
• Critically analyze and process third party and internal information requests and rejections in an effort to resolve accounts receivable.
• Critically analyze and process documents for resolution of third party liabilities, outstanding credits and un-billed accounts.
• Make all necessary posting, adjustments and refunds to accounts and critique contractual allowances and other arrangements.
• Responsible for complete understanding and application of current contracts and governmental regulations including referrals for legal intervention for multiple entities.
• Proficient in the revenue cycle process via multiple computer systems including but not limited to: Internal systems: EPIC, SSI, and External systems such as payer claims and eligibility systems.
• Verifies insurance eligibility using automated on-line systems.

Skills

Type 45 wpm

Effective communication

Analytical ability

Education

Associate's degree in business or Finance

Tools

EPIC

Billing systems

Eligibility systems

Job description

Bronson Methodist Hospital in Portage, MI is seeking a Reimbursement Specialist to ensure compliant billing and maximize reimbursement from third-party payers. You will handle billing, posting payments, and analyze CPT-4/ICD-10 to optimize revenue, while staying current with contracts and government regulations.

The role requires strong communication, typing speed, and knowledge of medical terminology, with experience in Epic or related billing systems.