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The Reimbursement Specialist is responsible for following up on hospital claims, managing secondary and subsequent payer accounts, and resolving reminder queues. Additionally, the role involves posting electronic payments, maintaining quality assurance standards, and providing customer service to patients and insurance companies.
Job Purpose: Responsibilities include patient account follow up on all types of hospital claims. This includes following accounts through secondary and subsequent payers. Must have thorough knowledge of hospital managed care contracts, standard collection processes and state and federal regulations. An understanding of medical terminology and diagnosis and procedure coding is needed.
Physical Demands & Working Conditions: The physical demands described here are representative of those that must be met by an employee to successfully to perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job the employee is regularly required to use hands to finger, grasp, handle, or feel and to reach with hands and arms. The employee is frequently required to sit, stand, walk, see, speak, and hear. The employee is occasionally required to kneel, climb, or balance. The employee is regularly required to lift up to 10 pounds and rarely lift more than 25 pounds. There will be prolonged periods of sitting and data entry.
* Performs other duties as assigned
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