Medical Billing & Reimbursement Specialist na RMX Monitoring, LLC

Job Specification – Medical Billing and Reimbursement Specialist

Reports to: Director, Reimbursement Services

Classification: Non-Exempt

Primary Responsibilities:

• Provide patient balance estimates, collect patient payments and verify insurance for all payers, including Medicare, Medicaid, and commercial insurances
• Answer and respond to telephone, voicemail, email, and faxed inquiries from internal and external customers, which include clients, patients, and insurance carriers
• Initiate, submit and obtain prior authorizations
• Process, sort, and direct incoming and outgoing mail to the appropriate teams and departments
• Maintain patient accounts by appropriately notating, updating, and collecting patient demographic, and insurance information
• Request medical records and other patient/provider information, when appropriate
• Process credit card transactions received from patients and insurance carriers
• Process patient financial hardship applications and reviews requests for account adjustments
• Adhere to appropriate quality control, confidentiality, and HIPAA guidelines
• Assist with insurance appeal and claim follow up activities
• Attend staff meetings
• Monthly reporting on performance and activities
• Other job duties, as assigned

Qualifications, Skills & Competencies:

• Bachelor’s degree, preferred
• 5 + years in customer service, insurance verification, authorization and insurance billing required
• Effectively prioritize work and manage time
• Ability to work in face paced transactional environment where multitasking, accuracy and meeting deadlines
• Capacity to make decisions, solve problems and work independently using established departmental standard operating procedures and guidelines
• Proficient in providing exceptional customer service
• Capable of identifying and escalating opportunities for process improvements to management team 
• Ability to identify insurance contract opportunities / requirements and communicate the same to payer relations
• Possess interpersonal skills that maintain and promote positive and professional working relationships with peers and management team
• Skilled at staying well-organized, focused, and detail oriented
• Adept in using effective and appropriate communication styles
• Flexible and willing to assist with to departmental and / or company procedural change
• Previous experience with medical claims processing, insurance verification, medical records and insurance terminology required
• Competency with Windows PC Applications, including Microsoft Word and Microsoft Excel; strong keyboard and navigation skills and ability to learn new computer skills & applications
• Ability to work a 40-hour schedule within the operating hours of the department, 8:30 AM to 9:30 AM start time and ending 5:00 PM to 6:30 PM
• It may be necessary, based on business and departmental need, to work occasional overtime and/or weekends.
• Telecommute work possible, subject to business environmental conditions

Benefits:

• Competitive salary and bonus structure
• Health, dental and vision insurance as well as other ancillary benefits
• Retirement savings plan – 401(k) – with company match
• Paid time off (PTO) and holidays
• Professional development and training opportunities
• Employee wellness programs

EEO Statement:

RMX Monitoring, LLC is an equal opportunity employer who openly supports and fully commits to recruitment, selection, promotion, and compensation of individuals without regard to race, color, religion, age, sex (including pregnancy, gender identity, and sexual orientation), genetic information, national origin, disability status, protected veteran status or any other characteristic protected by federal, state, and/or local laws.  Inclusion and diversity amongst our teams is essential to our success.