Reimbursement Specialist - Healthcare jobs in Clearwater, FL

THIS IS NOT A REMOTE ROLE

As our Reimbursement Analyst, you will take responsibility for obtaining and managing, accurate, timely completion and submission of all the authorization requests. You will also focus on billing, collections, and accounts receivable functions for Pinnacle Homecare and our assigned payor sources.

As part of our Dynamic Central Operations Team, you will:
· Bill payers in a timely and accurate manner.
· Daily collection activities for designated accounts, leading to the timely reimbursement of receivables using available resources including external/internal databases, payer portals/websites, and telephone
· Take appropriate action to resolve denied/rejected invoices and preparation of payer corrections and/or appeals in accordance with payer plan requirements using electronic and paper processes
· Calculate expected reimbursement percentages based on contracted rates and properly notate accounts.
· Daily Review of EOPs/EOB/Ras/EOMBs for accuracy and patient responsibility.
· Reconciles and collects on assigned accounts.
· Identify trends, and opportunities, and report data to your direct supervisor the same day.
· Meet productivity goals as assigned by the Billing/Reimbursement Manager.
· Utilize appropriate systems to actively contact Payers/Patients for account transactions.
· Ensures that all reconciled items and past due balances are resolved to completion through contact and follow-up with Payers/Patients.
· Communicates professionally with inter-company departments on a resolution of potential disputed items.
· Responds to all inquiries with a resolution to concerns and or discrepancies.
· Participates in payer webinars and conference calls covering a wide range of topics that enables the Billing Team to effectively bill and collect accounts receivable.
· Assists in the training of all new A/R personnel when needed.
· Complies with HIPAA regulations on all accounts
· Protects the confidentiality of patient and organization information through effective controls and direct supervision of operations.
· Additional Duties/Tasks may apply as the business needs of the company evolve.

The Talent Acquisition person who is responsible for this role enjoys sharing their enthusiasm for being part of an amazing organization, that works together for successful patient outcomes and has a passion for service to others. It will be well worth your time to have the conversation and expand your network. Apply today!