Medical Reimbursement Specialist Job at Robert Half (Princeton)

Medical Billing Specialist

Location

United States , Dothan

Salary:

Not provided

RealTime (AL)

Expiration Date

Until further notice

Requirements

Medical Billing Experience
Perform posting charges
Perform completion of claims to payers
Conduct duties in a professional and timely fashion
Submit billing data to the appropriate insurance providers
Process claims
Resolve denial instances
Perform claim follow-up
Achieve maximum reimbursement for services provided
Deploy, maintain and report on various programs

Job Responsibility

Medical billers play a vital role in the connection between health care providers, patients, and insurance companies. At RealTime, we provide excellent Revenue Cycle Management to medical practices across the Southeast and through the Midwest.

What we offer

Training
Competitive pay
Phone allowance
Generous PTO
401(k) with company match
Health & Wellness Benefits including medical, dental, and vision
Company-sponsored events for fun and fellowship

Fulltime

Medical Billing Specialist

We are looking for a detail-oriented Medical Billing Specialist to join a team i...

Location

United States , King of Prussia

Salary:

Not provided

Robert Half

Expiration Date

Until further notice

Requirements

At least 1 year of experience in medical billing, claims, or collections
Proficiency in accounting software systems and electronic health record (EHR) systems
Familiarity with Medicaid processes and commercial insurance claims
Strong understanding of accounts receivable, denial management, and appeals
Experience working with billing and authorization functions
Ability to accurately input and manage billing data
Excellent communication skills to collaborate with team members and external payors
Knowledge of compliance policies related to medical billing and collections

Job Responsibility

Process and submit primary and secondary claims for both commercial insurance and Medicaid
Investigate and resolve claim denials, performing appeals as necessary to ensure proper reimbursement
Manage accounts receivable by following up on claims through resolution, including correcting billing errors and addressing rejections
Input and review billing data for accuracy, ensuring compliance with company policies and procedures
Collaborate with the Billing Manager and clinic teams to ensure accurate and timely billing
Track and verify Medicaid status for clients while maintaining relationships with payors to facilitate successful claims processing
Assist intake teams with Medicaid documentation for new clients and those requiring reassessment
Utilize various insurance portals and systems, including Waystar, to handle denial responses and claims follow-ups
Ensure adherence to compliance standards in all billing and collections activities
Perform other tasks as assigned by the Billing Manager or Director

What we offer

Medical insurance
Vision insurance
Dental insurance
Life insurance
Disability insurance
401(k) plan

Fulltime

Billing Specialist

Location

United States

Salary:

Not provided

Pafford EMS

Expiration Date

Until further notice

Requirements

Proficient with a PC
Knowledge of Health Insurance Portability and Accountability Act (HIPAA)
Knowledge of procedure and diagnostic codes (HCPCS and ICD-10 codes)
Knowledge of medical terminology
Knowledge of Medical Billing
Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and commercial payers
Customer service skills for interacting with patients regarding medical claims and payments
Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
Ability to work independently and with a group
Working knowledge of MS Word, Excel

Job Responsibility

Obtain referrals and pre/post-authorizations for ambulance services
Check eligibility and benefits verification
Review insurance and facility claims for accuracy and completeness
Prepare, review, and transmit claims using billing software, clearinghouse, and payer websites
Following up on unpaid claims within standard billing cycle timeframe
Reviewing underpaid claims for appropriate escalation steps to ensure appropriate reimbursement for services
Calling insurance companies regarding any payment discrepancies
Identifying and billing secondary or tertiary insurance
Processing incoming mail and taking appropriate follow up actions to resolve accounts
Researching and appealing denied claims

Territory specialist

BrainWorks has partnered with a rapidly growing medical device manufacturer to b...

Location

United States , Las Vegas

Salary:

Not provided

BrainWorks

Expiration Date

Until further notice

Requirements

Four-year undergraduate degree from an accredited college or university
Highly organized with detailed and prompt follow-through
High level of personal and professional integrity and trustworthiness with strong work ethic
Can clearly and succinctly communicate in a variety of settings
Exceptional customer focus
Must live in assigned territory
Ability to travel up to 50% of the time via car and plane
Valid driver’s license with a clean driving record
Comfortable in working directly with patients and patient advocacy groups in their territory
1-3 years sales experience

Job Responsibility

Maintain and develop relationships with key customers in the assigned territory under general supervision of the Regional Director
Assist the Regional Director with implementing sales strategies to attain monthly, quarterly, and annual sales goals
Assist in providing customer support for training and reimbursement
Follow company processes to provide customer feedback and to report complaints or issues in a timely manner
Demonstrated competency in patient and clinician education and demonstration
Clearly communicate with different departmental teams to produce timely business outcomes
Demonstrate knowledge of third-party payer policies
Participate in local and national tradeshows and events as requested
Must maintain compliance with all appropriate regulatory requirements, including HIPAA
Complete required training, certifications, expense reports, and sales documentation and reporting as required

What we offer

Full medical, vision, and dental coverage
401k Plan Company Match
Paid Vacation, Holidays and Sick time
Milliage/travel reinbursement
Strong training program with ramp up/guarentee
Laptop and phone provided

Fulltime

Self-Pay Collection Representative III

Responsible for collecting receivables due from patient/responsible parties. Ide...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree and 3 years of hospital patient accounting or consumer collections experience required
Or equivalent combination of education and experience
Certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS) upon hire preferred

Job Responsibility

Resolves receivables due from patients
Identifies and prepares for appropriate action of those accounts which cannot be resolved amicably and requires legal or collection activity
Makes recommendation for write-off, resolves credit balances by, requests transfers and refunds, etc.
Documents and formalizes all actions to ensure compliance with university and legal requirements
Maintains records for effective reporting of efforts
Responds to patient written and verbal inquiries
Negotiates installment payment arrangements with the guarantor or a financially responsible individual that are equitable to both URMC and individual
Interacts with ancillary areas which impact receivables to resolve A/R problems and address patient problems delaying payment
Maintains a general knowledge of billing and collection regulations and procedures which affect A/R
Other duties as assigned

Fulltime

Claim Resolution Representative III

With latitude for initiative and independent judgment within department guidelin...

Location

United States of America , Rochester

Salary:

19.62 - 26.49 USD / Hour

University of Rochester

Expiration Date

Until further notice

Requirements

Associate's degree in business administration required
2 years of hospital/professional Patient Accounting, Consumer Collections experience, or Certification obtained from a nationally accredited billing program (i.e., Certified Medical Billing Specialist CMBS, Certified Medical Records Technician CMRT, Certified Medical Reimbursement Specialist CMRS) required
Or an equivalent combination of education and experience
Ability to type 25 wpm Required

Job Responsibility

Managing professional hospital accounts
Resolving balances of aged insurance accounts
Making independent decisions as to the processes necessary to collect denied insurance claims, no response accounts, and investigating resolving billing issues
Maintaining a detailed knowledge of billing requirements and regulations
Representing the department and Strong Memorial Hospital (SMH) in a professional manner, protecting confidentiality of patient information
Completes follow up activities on denied, unpaid, or under-paid accounts
Maintains a thorough knowledge of Professional Billing
Identify and clarify billing issues, payment variances and/or trends that require management intervention
Research and respond to third party correspondence, receive phone calls, explain policies and procedures
Participate in department staff meetings, education classes and training

Fulltime

Medical Coding Reimbursement Review Specialist

We are seeking an experienced and detail-oriented Medical Coding Reimbursement R...

Location

United States

Salary:

21.42 USD / Hour

MMC Group LP

Expiration Date

Until further notice

Requirements

Certified Medical Coder certification required through recognized organizations such as AAPC or AHIMA
CPC (Certified Professional Coder) preferred
CCS (Certified Coding Specialist) preferred
Strong inpatient coding experience required
3-5 years of medical coding and reimbursement review experience preferred
Experience with CPT codes, ICD-10-CM, and HCPCS coding systems required
Strong understanding of CPT modifiers and reimbursement impact required
Experience with retrospective coding reviews required
IDRE experience required
Must be able to explain the IDR process during the interview

Job Responsibility

Perform retrospective payment reimbursement reviews with a strong focus on inpatient coding
Analyze CPT codes, modifiers, and claim interactions to ensure accurate reimbursement determinations
Review and interpret Explanations of Benefits (EOBs), including recoupments, corrections, denials, and claim adjustments
Evaluate how CPT modifiers impact reimbursement and payment outcomes
Conduct coding reviews across multiple provider specialties with broad CPT code knowledge
Review medical claims for compliance with coding standards and reimbursement guidelines
Prepare clear, accurate, and final binding payment determination letters for clients and disputing parties
Support Independent Dispute Resolution (IDR) cases and demonstrate knowledge of the full IDR process
Maintain compliance with billing regulations, coding standards, and applicable healthcare laws
Manage multiple priorities effectively while meeting strict deadlines in a high-volume environment

What we offer

Medical, dental, and vision coverage
Life and disability insurance
Additional voluntary benefits

Fulltime