Temp - Administrative - Reimbursement Specialist (Days) Beverly MA

United Health System Inc; Beverly (MA); Remote; USD 50,000 - 70,000; Full time

Job summary

A leading healthcare provider in the United States is looking for a remote Billing & Reimbursement Specialist I. This role requires extensive experience in billing and claims management, focusing on accurate billing and efficient revenue collection from various health insurance carriers. Successful candidates will be detail-oriented with a strong understanding of the revenue cycle and essential healthcare reimbursement processes.

Qualifications

• 5+ years experience with collections and claims follow-up required.
• Experience with full revenue cycle, Medicare, and Veterans Affairs reimbursements required.
• Dialysis or healthcare experience required.

Responsibilities

• Handles accurate billing and revenue collection for dialysis facilities.
• Tracks claim status, composes claims appeals, and manages high volume claims.
• Builds effective relationships with insurance carriers and representatives.

Skills

Excel

VLOOKUP

PivotTable

Claim resolution

Bilingual (Spanish/English preferred)

Education

Bachelor's degree in business or healthcare management

Tools

Microsoft Office Suite

Job description

THIS IS A FULLY REMOTE POSITION!

The Billing & Reimbursement Specialist I is assigned to a group of dialysis facilities and is responsible for accurate and efficient billing and collection of health insurance payments from insurance carriers. The specialist coordinates, documents, and communicates with insurance representatives regarding proper insurance payments in accordance with policies, procedures, and current standards, guidelines, and regulations.

Essential Functions

1. Responsible for accurate billing and revenue collection for respective financial classes.
2. Demonstrates advanced knowledge of the respective financial class.
3. Obtains and tracks claim status via phone and online portals.
4. Composes and follows up on claims appeals.
5. Identifies, addresses, submits, and processes adjustments appropriately.
6. Reviews and understands Explanation of Benefits documents.
7. Builds effective working relationships with insurance carriers and representatives.
8. Allocates coinsurance and deductibles timely within applicable databases.
9. Effectively manages a high volume of claims and complex accounts.
10. Applies solid billing and reimbursement knowledge, exercising independent judgment to troubleshoot and guide next steps.

Submission Requirements

1. 5+ years experience with collections and claims follow-up - REQUIRED
2. Experience with full revenue cycle, including Medicare and Veterans Affairs reimbursements - REQUIRED
3. Strong background in claim resolution (claims follow-up/denial management) - REQUIRED
4. Ability to identify high-priority claims aging areas; self-motivated and independent - REQUIRED
5. Bachelor's degree in business or healthcare management - REQUIRED
6. Knowledge of Excel, PivotTable, and VLOOKUP - REQUIRED
7. Proficiency in Microsoft Office Suite - REQUIRED
8. Dialysis or healthcare experience - REQUIRED
9. Bilingual (Spanish/English preferred; other languages a plus) - REQUIRED

Brief Company Intro

United Health System is a well-known healthcare provider in the United States. We prioritize being Customer-oriented, Compassionate, Candid, and Compliant. Committed to your success, we foster teamwork and strive for excellence. Our principles emphasize honesty and sincerity, aiming to deliver the best results for our clients and employees through simple, effective strategies.