Job Description

Job Summary

The Reimbursement Specialist I is responsible for supporting the accurate and timely processing of claims and reimbursement activities. This role involves verifying account information, applying appropriate codes, and ensuring compliance with billing and reimbursement guidelines. The Reimbursement Specialist I collaborates with team members to maintain efficient workflows and contributes to meeting productivity and accuracy standards within the department.

Essential Functions

Processes and verifies claims and reimbursement transactions to ensure accuracy and compliance with guidelines. Reviews account balances and applies appropriate transaction codes to facilitate accurate account flow. Identifies any discrepancies in claims and takes appropriate actions, including adjustments or referrals as necessary. Monitors account status to ensure timely follow-up on outstanding balances and claims. Maintains departmental productivity and quality standards, adhering to established timelines. Performs other duties as assigned. Complies with all policies and standards.

Qualifications

H.S. Diploma or GED required Coursework in Accounting, Finance, Healthcare Administration, or related field preferred 0-1 years in billing, accounts receivable, or reimbursement, ideally within a healthcare setting required

Knowledge, Skills and Abilities

Knowledge of basic billing, reimbursement, and transaction processing principles. Proficiency with account management software and department-specific technology. Strong attention to detail to ensure accuracy in claim processing. Effective communication skills to work collaboratively within the team. * Ability to meet productivity standards and contribute to departmental goals.