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Medicare Reimbursement Specialist - Atlanta, GA
| Hours | Full-time, Part-time |
|---|---|
| Location | Atlanta, GA Atlanta, Georgia |
About this job
This
function is responsible for insurance denial resolution. Positions in
this function contact payers to determine reason for payment denial.
Handles all unresolved inquiries/ issues from payers and patients.
Responsible for interpreting and applying organization policies on
collection practices. May work with or outside agencies in more complex
collection cases.
Primary Responsibilities:
- Some work is completed without established procedures
- Basic tasks are completed without review by others
- Supervision/ guidance is required for higher level tasks
- Contact customers to determine reason for payment delinquency
- Negotiate and advise on collection of overdue bills and take appropriate action to recover overdue payments
- Handle unresolved inquiries/ issues
- Responsible for developing, implementing, maintaining and managing organization policies on collection practices
- May work with outside legal counsel and/ or outside agencies in more complex collection cases
- Moderate work experience within own function
Requirements
- High School Diploma/ GED
2+ years Hospital billing/collections experience
2+ years patient Accounting experience with a focus on Medicare Part A and Part B
2+ years previous experience with UB04 and CMS1500
Hospital follow up experience within last 3 years
Must be able to resolve Medicare Denials and read and interpret EOBs (Explanation of benefits)
In-depth understanding of cross-over claims
- Working hours will be from 7am to 7pm Monday to Friday (Will work 8 hours during the hours of operation).
Assets:
Working knowledge of Florida Shared System (FSS)
Working knowledge of Medicare CWF/ HIQA, and denial resolution
- Proficiency with Client Payment systems (i.e. E-Premise, Emdeon, Star, Meditech, and Siemens)
- Experience with DDE (Direct Data Entry) systems
- CPAR, CPAT, or CPC/ H certification
Healthcare
isn't just changing. It's growing more complex every day. ICD-10 Coding
replaces ICD-9. Affordable Care adds new challenges and financial
constraints. Where does it all lead? Hospitals and Healthcare
organizations continue to adapt, and we are vital part of their
evolution. And that's what fueled these exciting new opportunities.
Who
are we? Optum360. We're a dynamic new partnership formed by Dignity
Health and Optum to combine our unique expertise. As part of the growing
family of UnitedHealth Group, we'll leverage our compassion, our
talent, our resources and experience to bring financial clarity and a
full suite of Revenue Management services to Healthcare Providers,
nationwide.
If you're looking for a better place to use your
passion, your ideas and your desire to drive change, this is the place
to be. It's an opportunity to do your life's best work.
Diversity
creates a healthier atmosphere: All qualified applicants will receive
consideration for employment without regard to race, color, religion,
sex, national origin, protected veteran status, or disability status.
UnitedHealth Group
is a drug-free workplace. Candidates are required to pass a drug test
before beginning employment. In addition, employees in certain positions
are subject to random drug testing.