Senior Medical Contract Reimbursement Specialist

University of Miami; Oregon; Hybrid; USD 42,000 - 60,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Tuition remission

Job summary

University of Miami is seeking a full-time Contract Reimbursement Representative to ensure accurate reimbursement practices for complex payer scenarios in a fast-paced health system environment.

The role involves reviewing credits, interpreting contract rates, and liaising with multiple departments to resolve inquiries while ensuring compliance with Florida laws and confidentiality of patient information.

Qualifications

• High school diploma required.
• At least 1 year of medical billing and collections experience.
• EPIC experience preferred.
• Excellent verbal and written communication skills in English.
• Strong organizational skills and ability to multi-task in a high-stress environment.
• Knowledge of state/federal hospital regulations and medical terminology.
• Ability to maintain confidentiality of patient information.

Responsibilities

• Review credits within the assigned WQs for proper resolution with payers, patients, and other entities.
• Review and interpret contract rates to ensure proper reimbursement and EOBs.
• Liaise between Credit Balance Unit and external departments, vendors, patients, and third-party payers to address inquiries.
• Review refund requests submitted by payers and patients and submit appeal letters within deadlines.
• Apply Florida statutes to commercial payers.
• Assess patients’ coverage, eligibility, and pre-authorizations.
• Process refunds via check, credit card portal, and wire transfer.
• Provide ongoing in-service training for onboarding staff and vendors.

Skills

Verbal communication

Written communication

Organizational skills

Multitasking

Analytical thinking

Problem solving

Interpersonal skills

Customer service

Confidentiality

Education

High school diploma

Tools

Epic

Job description

University of Miami is seeking a full-time Contract Reimbursement Representative to ensure accurate reimbursement practices for complex payer scenarios in a fast-paced health system environment.

The role involves reviewing credits, interpreting contract rates, and liaising with multiple departments to resolve inquiries while ensuring compliance with Florida laws and confidentiality of patient information.