ReBound este o familie de mărci dedicate unui stil de viață activ, care dezvoltă produse de larg consum pentru utilizarea de zi cu zi. Compania se concentrează pe designuri practice și plăcute și pe inovarea continuă a produselor, cu activități în retail, comerț electronic și logistică.
Medical Accounts Receivable Specialist
Process physician and ambulatory surgery center claims in Epic, resolving denials and improving clean claim rates and reimbursement for Rebound’s patient-focused medical organization.
Descriere
- Prepare and resolve insurance claims for physician and ambulatory surgery center services.
- Submit professional and facility claims electronically through Epic and its clearinghouse interface.
- Review Charge Review and Claim Edit queues to verify claim details and correct errors before submission.
- Check coverage, place of service, provider details, and coding accuracy before releasing claims.
- Resubmit corrected claims and follow up on rejected or pending submissions.
- Manage the Charge Review, Claim Edit, and Follow up work queues each day.
- Refer billing discrepancies to coding, registration, or contracting teams as appropriate.
- Spot recurring edit problems and escalate them for root-cause investigation.
- Review payer rejections and denials in Epic, correct issues, and resubmit claims.
- Contact insurers by phone and through their online portals.
- Record claim actions in account notes to support audit records and team coordination.
- Apply CMS and commercial payer billing rules, including NCCI edits, modifiers, and place-of-service requirements.
- Keep informed about payer-specific rules for professional and facility claims.
- Maintain billing knowledge for evaluation and management, surgical, and ancillary services.
- Advance Rebound’s mission and uphold its Core Values.
- Complete other duties as assigned.
Cerințe
- High school diploma or equivalent.
- At least two years of medical billing experience in a healthcare setting, such as a physician’s office, hospital, or clinic.
- Experience with collections, customer service, and insurance billing and reimbursement is preferred.
- Working knowledge of CPT and ICD-10 coding, HCPCS, modifiers, and payer billing rules.
- Experience with Medicare, Medicaid, and commercial insurers.
- Ambulatory surgery center billing experience is preferred.
- Relevant education may replace applicable experience, or an equivalent combination of education, training, and experience may qualify.
- Knowledge of insurance billing processes, collection laws, and medical terminology is preferred.
- Strong verbal and written communication and public relations skills.
- Able to work independently and collaboratively with staff and teams with limited supervision.
- Strong problem-solving and critical-thinking skills.
- Proficient with computers, including Microsoft Office applications.
- Able to apply service excellence principles and maintain a professional, customer-focused manner in busy or difficult situations.
- Typing speed of at least 35 words per minute.
- Able to use a keyboard, calculator, telephone, copier, and other office equipment.
- Able to occasionally lift files or paper weighing up to 30 pounds.
- Able to view and type on computer screens for extended periods.
- Able to comply with HIPAA rules and regulations.
Beneficii
- Medical, vision, and prescription coverage.
- Dental coverage.
- 401(k) retirement plan with discretionary profit sharing.
- Company-paid life insurance and accidental death and dismemberment coverage.
- Voluntary life insurance and accidental death and dismemberment coverage.
- Company-paid short- and long-term disability coverage.
- Flexible spending and health savings accounts.
- Employee assistance program.
- Free parking.
- Paid time off accrues at up to 24 days in the first year, based on FTE.
- Monday through Friday schedule with no weekends or holidays.
- Full-time position, 40 hours per week.