Strategic Payer Reimbursement Specialist

Rogers Memorial Hospital; Town of Oconomowoc (WI); On-site; USD 52,000 - 76,000; Full time

Job summary

Rogers Memorial Hospital is seeking a Reimbursement Specialist to support the Reimbursement Supervisor and team in navigating commercial and governmental payers, resolving billing issues, and ensuring timely reimbursements. The role emphasizes collaboration with departments to improve collections and training for new staff.

The position involves analyzing denials, monitoring payment variances, and promoting best practices in the revenue cycle while maintaining HIPAA compliance and professional

Qualifications

• High school diploma or equivalent required.
• Associate or bachelor's degree preferred.

Responsibilities

• Identifies and analyzes underpayments to determine the reasons for discrepancies and processes denials and appeals; examines claims to ensure payers are complying with contractual agreements.
• Reviews posted payments to ensure accuracy; analyzes explanation of benefits to ensure proper reimbursement.
• Communicates directly with payers to follow up on outstanding claims and resolve payment variances, responds to payer inquiries and concerns, and works to develop and maintain positive relationships with payers.

Job description

Rogers Memorial Hospital is seeking a Reimbursement Specialist to support the Reimbursement Supervisor and team in navigating commercial and governmental payers, resolving billing issues, and ensuring timely reimbursements. The role emphasizes collaboration with departments to improve collections and training for new staff.

The position involves analyzing denials, monitoring payment variances, and promoting best practices in the revenue cycle while maintaining HIPAA compliance and professional