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Medical Reimbursement Specialist

https://www.roberthalf.com Logo

Robert Half

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Location:
United States , Princeton

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Category:

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Contract Type:
Not provided

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Salary:

Not provided

Job Description:

We are in search of a Medical Reimbursement Specialist to join our team. Stationed in Princeton, New Jersey, you will be instrumental in tackling a backlog of aged medical claims and refining our reimbursement process. This role offers a long-term contract employment opportunity in the medical industry, where you will be tasked with tasks such as claims processing, denial management, payer follow-ups, and appeals.

Job Responsibility:

  • Analyze and categorize outstanding claims based on payer, denial reason, and claim value
  • Investigate and take corrective action on unpaid, denied, or underpaid claims
  • Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
  • Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
  • Submit corrected claims and formal appeals as required
  • Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
  • Maintain comprehensive records of all payer interactions
  • Identify the root causes of denials and implement best practices to prevent future issues
  • Suggest changes to workflow to enhance claim submission accuracy and speed
  • Conduct training for in-house billing teams on claim recovery strategies

Requirements:

  • Minimum of 3 years of experience in a similar role
  • Proficient in benefit functions
  • Demonstrated expertise in billing functions
  • Experience in claim administration
  • Familiarity with collection processes
  • Ability to handle and resolve medical denials
  • Comprehensive knowledge of Medicare
What we offer:
  • medical, vision, dental, and life and disability insurance
  • eligibility to enroll in company 401(k) plan

Additional Information:

Job Posted:
March 25, 2025

Employment Type:
Fulltime
Work Type:
On-site work
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