Reimbursement Specialist

Woodbury, MN

Requisition Number: REIMB001824

Apply Online

Posted on June 13, 2022

Personal Growth. Expansion. Teamwork. Innovation. Be a part of a truly patient-first environment and an organization that cares about their employees.

 Under the direct supervision of the Reimbursement Manager, the Reimbursement Specialist will follow up with the intent of collecting all delinquent unpaid insurance and patient balances.

  • Work Centricity Work Queues on a daily basis in accordance with Business Office policies and procedures.
  • Knowledgeable in payer Orthopedic and PT policies and remain current with payer policies and protocols, sharing information within organization.
  • Maintain account aging with emphasis on resolution of accounts more than 120 days from date of service.
  • Identify, research and resolve any issues preventing payment of accounts.
  • Understanding and adherence to standard accounting principles.
  • Communicate daily with insurance carriers, patients, medical office staff, and other third parties to collect outstanding balances due, resolve disputes, denials and general nonpayment issues
  • Provide support and back up for Patient Financial Services Representatives.
  • Prevent “timely filing” denials by strict adherence to guidelines set by carriers for follow-up on initial claim filings and subsequent claim denials.
  • Work all patient and insurance carrier refunds within established parameters.
  • Act as back up to Receipts area, posting payments to patient accounts according to established policies.
  • Review and approve accounts for collection agency placement.
  • Perform due diligence in resolving outstanding balances ensuring all efforts have been exhausted in resolving issues with payers before writing off to bad debt, transferring to the next payer level or patient responsibility.
  • Effectively maintain a high level of professionalism when contacting patients, insurance carriers, facilities and clinics and other 3rd party parties while adhering to HIPAA regulations and privacy practices.

This position will be full-time and will be based at the Corporate Office in Woodbury with a current schedule of Monday 8:30am - 5:00pm (subject to change)  This role will have a focus on bundled procedure procession. 

Summit Health ASO, provides administrative and clinical support to our full spectrum of orthopedic care services in our sub-specialty clinics, walk-in care at our OrthoQUICK clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert teams are part of the 800+ employees who partner to provide quality services and care designed to support a healthier, more active lifestyle.

 Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

Education

  • Preferred: Some post college in Business Administration
  • Required: High School

Experience

  • Required: Minimum of 4 years of third party billing experience in a Business Office setting is required. Extensive knowledge of third-party and government payer practices and requirements. Experience with medical software (PM, EMR, EHR). High school diploma or general equivalency diploma (GED) required; post-secondary education in business or medical billing preferred.