Reimbursement Specialist (Full Time) - #259881

Lake Charles Memorial Health System


Date: 13 hours ago
City: Lake Charles, LA
Contract type: Full time
Description Of Position

  • Reimbursement specialists are responsible for evaluating and overturning denials to provide denial trend information to leadership. As an integral role of the Claims Escalation Team, the Reimbursement Specialist monitors outstanding payer issues and provides intensive follow up to ensure billing, coding, and collection process are followed to maximize reimbursement.

SUPERVISION: Reports directly to the Office Manager

Responsibilities And Duties

  • Accurately identifies and evaluates denials and underpayments in order to determine reason and investigates the issue to determine the best course of action to have payer pay at the maximum reimbursement allowed per our contract.
  • Understands payer contracts and how to analyze them in order to preview an account to determine if properly paid and identify when errors are made in payments.
  • Utilizes system resources in order to compile reports and provide accurate feedback regarding Denials and Underpayments to Leadership.
  • Communicates effectively with assigned payer, other departments and leadership to identify trends, help find solutions and implement changes that will positively affect reimbursement.
  • Accurately evaluates each account in order to determine what is needed, what is left outstanding, and what steps are necessary to resolve the account quickly.
  • Properly utilizes productivity tracking mechanisms.
  • Works at or above the weekly set productivity standard and completes tasks in a timely manner.
  • Appropriately prioritizes work queue in order to work highest priority first based on assigned subjects.
  • Documents all information in the System following the Clear Concise Consistent method.
  • Consistently monitors assignment to ensure that all steps necessary to assist the Team with achieving its goals have been taken.
  • Writes clearly and informatively.
  • Edits work for spelling and grammar.
  • Varies writing style to meet needs.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

Education And Work Experience

  • High school graduate or GED certificate, required.
  • Minimum of 2-year experience in Healthcare, preferably in the insurance industry
  • Proficient in Microsoft Office suite
  • Analytical and problem-solving skills
  • Excellent communication and interpersonal skills
  • Ability to work well in a team environment
  • Adequate keyboarding skills (40 words per minute typing rate)
  • Strong organizational and communication skills, including ability to discuss medical issues.
  • Negotiation skills including assertiveness and being proactive.

PHYSICAL DEMANDS/WORK ENVIRONMENT

  • Work requires a variety of physical activities, including moving about within and outside of all hospital properties for long periods of time.
  • Must be able to respond quickly and effectively to emergency and non-emergent situations.
  • May be required to assist in controlling disorderly conduct or combative patients.
  • Must be able to exchange accurate information with patient, family, peers and medical personnel.
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

“Experience Memorial” is more than a slogan, it’s the care we provide our patients and it’s the commitment to our community and our team members. As a nationally certified Great Place to Work, at Lake Charles Memorial Health System you will have the opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees. Join us and be a part of a team where your contributions are valued, your growth is nurtured, and your success is celebrated.

Working at Lake Charles Memorial Health System | Great Place To Work

How to apply

To apply for this job you need to authorize on our website. If you don't have an account yet, please register.

Post a resume

Similar jobs

Restaurant Host-Cashier

Golden Nugget Las Vegas, Lake Charles, LA
$10 - $14 per hour
2 days ago
Overview Host - Cashier A Host - Cashier is the first point of contact for guests and is responsible for presenting exceptional customer service to ensure the guests’ first impression of the restaurant is a positive one. Responsibilities Greet and welcome guests as they arrive at the restaurant with a genuine smile and positive attitude Engage with guests, anticipate their...

I&E Engineer

Indorama Ventures: Indovinya, Lake Charles, LA
2 weeks ago
Have you ever thought about being part of a team that is reimagining chemistry to create a better world every day? That's the purpose of Indorama Ventures! We are looking for innovative, collaborative professionals who are willing to face the challenge of working for a company that is expanding internationally. We are flexible, we are partners, and we believe that...

STAFFING COORDINATOR- Full Time

Lake Charles Memorial Health System, Lake Charles, LA
3 weeks ago
Description Of Position The Staffing Coordinator is designated to ensure proper staffing for Nursing Admin. SUPERVISION: Reports directly to Director of House Supervision Responsibilities And Duties Assess, evaluate and calculate daily staffing needs (to meet core staffing needs) of each inpatient unit in the organization. Receives all employee (patient care areas) call-ins and adjust schedules to maintain suitable staffing levels....