Billing & Reimbursement Specialist - Healthcare Revenue Cycle

Billing & Reimbursement Specialist - Healthcare Revenue Cycle

Overview:

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

Essential Functions

• Responsible for accurate billing and collecting of revenue for respective financial classes.
• Obtains and tracks claim status via phone and online portals.
• Composes and follows up on claims appeals.
• Appropriately identifies, addresses, submits, and processes adjustments.
• Reviews and understands Explanation of Benefits.
• Builds effective relationships with insurance carriers and representatives.
• Allocates coinsurance and deductibles timely and appropriately within the applicable database.
• Responsible for reviewing and addressing incoming mail correspondence.
• Communicates effectively verbally and in writing with patients regarding insurance checks.
• Collaborates effectively with other internal departments.
• Adapts and is flexible when change arises and demonstrates a willingness to learn new skills.
• Completes and maintains facility reports on a regular basis and reviews for any issues.
• Maintains strict confidentiality of patient personal information.
• Maintains HIPAA compliance.
• Understands the business implications of decisions.
• Performs additional tasks, duties, and projects as assigned.

Required Education and Experience

• Bachelor's degree in business or healthcare management strongly preferred.
• 0-2 years of experience as a billing and reimbursement specialist or as an insurance collector.
• Experience in dialysis and/or healthcare is preferred.
• Proficiency in Microsoft Office Suite.
• Excellent customer service skills, demonstrated ability to actively contribute as a team player, and superior attention to detail.
• Demonstrated ability to work in a fast-paced environment while maintaining high standards of accuracy.

About Innovative Renal Care
At Innovative Renal Care (IRC), we are one of the largest dialysis service providers in the U.S., partnering with local physicians to deliver high-quality care to patients with ESRD and other kidney conditions. Our mission is to be the trusted experts and preferred partners for patients, physicians, and healthcare providers by delivering best-in-class care, service, and solutions.

Our values, summarized as I CARE, guide everything we do:

• Integrity & Innovation: Earn trust by delivering on promises and finding new ways to solve problems.
• Compassion: Treat patients, their families, and colleagues with respect and empathy.
• Accountability: Take responsibility and show appreciation for others.
• Results Driven: Strive to exceed expectations and achieve excellence.
• Everyone Counts: Foster diversity, equity, teamwork, and collaboration.

Equal Opportunity Employer:

Innovative Renal Care is an equal opportunity employer and a drug free workplace. All qualified We applicants will receive consideration for employment without regards to race, color, religion, sex, sexual orientation, gender identity, national origin, citizenship, disability, or protected veteran status.

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