Summit Orthopedics

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Senior Reimbursement Specialist

at Summit Orthopedics

Posted: 7/15/2019
Job Status: Full Time
Job Reference #: 19-0134

Job Description

Requisition Number

Post Date

Senior Reimbursement Specialist

Employment Type
Full Time

Work Hours

Hours per week



Personal Growth. Expansion. Teamwork. Innovation. Be a part of a truly patient-first environment and an organization that cares about their employees.

Under the direct supervision of the Reimbursement Manager, the Reimbursement Specialist will follow up with the intent of collecting all delinquent unpaid insurance and patient balances.

Perform monthly audit and daily maintenance tasks as assigned.
Participate in new hire training and new process development.
Assist with ongoing process implementation.
Work Centricity Work Queues on a daily basis in accordance with Business Office policies and procedures.
Knowledgeable in payer Orthopedic and PT policies and remain current with payer policies and protocols, sharing information within organization.
Maintain account aging with emphasis on resolution of accounts more than 120 days from date of service.
Identify, research and resolve any issues preventing payment of accounts.
Understanding and adherence to standard accounting principles.
Communicate daily with insurance carriers, patients, medical office staff, and other third parties to collect outstanding balances due, resolve disputes, denials and general nonpayment issues
Provide support and back up for Patient Financial Services Representatives.
Prevent "timely filing" denials by strict adherence to guidelines set by carriers for follow-up on initial claim filings and subsequent claim denials.
Work all patient and insurance carrier refunds within established parameters.
Act as back up to Receipts area, posting payments to patient accounts according to established policies.
Review and approve accounts for collection agency placement.
Perform due diligence in resolving outstanding balances ensuring all efforts have been exhausted in resolving issues with payers before writing off to bad debt, transferring to the next payer level or patient responsibility.
Effectively maintain a high level of professionalism when contacting patients, insurance carriers, facilities and clinics and other 3rd party parties while adhering to HIPAA regulations and privacy practices.
Perform other duties as assigned based on needs of department and/or company.

Summit Health ASO, provides administrative and clinical support to our full spectrum of orthopedic care services in our sub-specialty clinics, walk-in care at our OrthoQUICK clinics, imaging, bracing, therapy, surgery, and post-surgical stays at our Care Suites. Our expert teams are part of the 900+ employees who partner to provide quality services and care designed to support a healthier, more active lifestyle.

Summit Orthopedics is committed to providing equal opportunity to all employees and applicants for employment in accordance with all applicable laws and regulations of federal, state and local governing boards and/or agencies.

High school diploma or general equivalency diploma (GED) required; post-secondary education in business or medical billing preferred.

Minimum of 5 years of third party billing experience in a Business Office setting is required. Extensive knowledge of third-party and government payer practices and requirements. Experience with medical software (PM, EMR, EHR).

Excellent written and verbal communication skills.
Familiar with medical terminology.
Fast and accurate keyboarding and ten key skills.
Computer knowledge and ability to work within a variety of software programs.
Must be confidential in all business-related matters and be knowledgeable in HIPAA regulations.
Capable of relating to diverse age, demographic, and cultural backgrounds.
Must be able to speak, read and write English fluently.
Display a professional attitude and approach to working environment.
Interact with all levels of staff within office in a professional and courteous manner.
Adhere to corporate policies and procedures as expressed in Employee Manual and/or in staff meetings.
Follow Business Office Policies and Procedures.
Maintain a position of willingness and cooperativeness with fellow team members and provide support to other team members when needed. In addition, request assistance in a timely manner.
Work independently when appropriate training has been completed.
Keep work space clear and uncluttered, leaving no patient information visible when away from workstation or at the end of the day.
Keep Supervisor/Manager apprised of any issues and concerns preventing and/or disrupting daily work flow.
Maintain strict confidentiality in all dealings related to patients, physicians, accounts, fellow employees, adhering to company HIPAA, Privacy and Confidentiality Policies.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!