Bronson Methodist Hospital
Southwest Michigan health system
Reimbursement Specialist
About the job
- A high school diploma or general education degree (GED) is required.
- Strong computer and general office equipment knowledge is required.
- Ability to type 45 words per minute is necessary.
- Ability to effectively communicate with patients, customers, and co-workers.
- Ability to quickly analyze communication style based on the nature and approach of a verbal inquiry.
- Successful completion of EUPAs for all Epic applications associated with the position within the first 90 days.
- Facilitate payment from third-party payers through correct billing, statusing and collection, posting third-party payments when applicable, computing correct reimbursement, processing correspondence, and maintaining knowledge of current contracts and government regulations for multiple entities.
- Ensure claims comply with payer specifications and state, federal, and HIPAA regulations.
- Resolve billing issues early to promote reimbursement, reduce outstanding revenue, and reduce time spent on rejections or additional claim follow-up.
- Prepare documentation to maximize reimbursement.
- Analyze CPT-4, ICD-9, UB-04, HCFA 1500, and charges for accuracy and to maximize reimbursement from third-party payers.
- Analyze and process third-party and internal information requests and rejections to resolve accounts receivable.
- Analyze and process documents to resolve third-party liabilities, outstanding credits, and unbilled accounts.
- Post necessary adjustments and refunds to accounts and critique contractual allowances and other arrangements.
- Understand and apply current contracts and governmental regulations, including referrals for legal intervention for multiple entities.
- Use multiple internal and external computer systems in the revenue cycle process, including STAR, EC2000, EPIC, SSI, GLMI Home Health Billing System, and payer claims and eligibility systems.
- Verify insurance eligibility using automated online systems.
- An Associate's degree in Business or Finance, or equivalent experience in medical billing, receivables, or collections, is preferred.
- Knowledge of medical terminology, ICD-9 and CPT-4 coding, national billing forms, third-party payers, managed care, reimbursement, and regulatory compliance is preferred.
About the company
Bronson Methodist Hospital is a nonprofit health system serving southwest Michigan. The system provides hospital, primary, specialty, emergency, outpatient, rehabilitation, and community health services through regional care locations. It serves patients, families, clinicians, referring providers, and communities throughout southwest Michigan. Its operating model centers on coordinated hospitals and practices supported by clinical programs, technology, facilities, supply chain, and administration. Teams work across nursing, physicians, allied health, rehabilitation, technology, facilities, administration, and patient access. Work depends on coordination among clinical, operational, technical, and support teams across its care settings and communities.
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