Reimbursement Specialist

Date Posted: May 12, 2022

Deadline: June 10, 2022

Organization: Greenwood Genetic Center

City: Greenwood

Website: View Website

Job Type: Full Time

Requirements:

Required Skills/Abilities:

  • Strong critical thinking skills
  • Self-motivated and self-directed with the ability to work independently and as part of a team
  • Ability to maintain strong relationships with physicians, employees, patients, and customers.
  • Excellent organizational skills, time management skills and attention to detail
  • Proficient in working with computer to include familiarity with Microsoft Office products, Electronic Medical Records and electronic claims software.
  • Strong customer service skills to include being comfortable discussing billing issues with both patients and insurance companies
  • Excellent verbal and written communication skills

Physical Requirements:

  • Prolonged periods of sitting at a desk and working on a computer.
  • Must be able to lift up to 15 pounds at times.
Job Description:

Job Summary:

The Reimbursement Specialist will be responsible for working with referring providers and/or patients to assist with preauthorization, billing, and reimbursement issues related to genetic testing, visits or consults provided by GGC.

Supervisory Responsibilities:

  • May assist in training newly hired and established employees in areas related to insurance reimbursement, preauthorization, and collections.

Duties/Responsibilities:

  • Perform daily activities of preauthorization submissions, billing, and auditing of accounts to ensure accurate claims submissions and optimization of reimbursement from commercial/governmental payers, clients, and payers for services provided.
  • Document eligibility, benefit, and authorization information in accordance with established guidelines.
  • Verify prior authorizations and/or pre-service requirements are met.
  • Proactively manage and maintain all outstanding authorization accounts to increase billing of clean claims.
  • Provide outstanding customer service to patients and develop and maintain positive working relationships with internal and external customers.
  • Document all account activity and correspond to inquiries in a timely manner.
  • Work as part of the accounts receivable operations to resolve open balances with payers.
  • Escalate payer issue trends for leadership consideration along with possible solutions.
  • Exhibit a good understanding of genetic services provided, as well as fee practices, with the ability to recognize areas of possible difficulty and take appropriate steps.
  • Assist in resolution efforts for payers assigned within the AR department.
  • Communicate and work effectively with colleagues from all departments.
  • Support training of new and existing personnel specialists with tasks related to the preauthorization and reimbursement function.
  • Consistently follow written and verbal communications and internal processes, as well as meet or exceed monthly quality and productivity standards.
  • Perform other related duties as assigned.

Education and Experience:

  • Bachelor’s degree preferred, with relevant experience in patient billing, preauthorization or insurance verification.
  • Demonstrated knowledge of health insurance plans including Medicare, Medicaid, HMO’s and PPO’s beneficial.
Schedule:
Monday-Friday, 8:00am-5:00pm
Contact Name:
Talitha Kay
Contact Phone Number: 864-941-8125
Contact Email: tkay@ggc.org
Application Process:
Apply on company website.
Employer Address:

101 Gregor Mendel Circle
Greenwood, SC 29646
United States

Our organization does not discriminate on the basis of race, color, religion, national origin, age, sex, sexual orientation, or disability.