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For your reference, we have included the original job posting below.
Reimbursement Rep
Job Number:
36463535
Company Name:
Addison Search
Job Location:
Plano, TX US
Job Category:
Accounting & Finance
Reimbursement Rep
Category: Healthcare
Direct Hire
SUMMARY: The High Level Commercial Collector files insurance and collects on accounts assigned in a timely and accurate manner. ESSENTIAL DUTIES AND RESPONSIBILITIES:
Reviews EOB/EOMBs for proper reimbursement.
Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner.
Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment.
Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed. Provides insurance carriers with requested information to facilitate payment.
Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits.
Performs claim appeals as required; must be able to write their own appeal letters using prompt pay guidelines to argue/support the appeal.
Assists with credit balance resolution.
Completes re-bill request as necessary to facilitate timely and proper claims payment.
Follows up on unresolved account balances including RTPs.
Prepares adjustment and write-off requests as necessary.
Performs other duties and responsibilities as required or assigned.
Researching problems with out of network collections. EDUCATION and/or EXPERIENCE:
High School diploma or GED required.
Minimum of five years of experience in health/medical collections.
Must have analytical skills.
Strong knowledge/experience using Microsoft Excel.
