Reimbursement Specialist - HonorHealth
PHOENIX, AZ 85027
About the Job
Overview:Looking to be part of something more meaningful? At HonorHealth, you’ll be part of a team, creating a multi-dimensional care experience for our patients. You’ll have opportunities to make a difference. From our Ambassador Movement to our robust training and development programs, you can select where and how you want to make an impact.
HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more.
Join us. Let’s go beyond expectations and transform healthcare together.
HonorHealth is one of Arizona’s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 15,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com.Qualifications:Education
High School Diploma or GED Required
Experience
1 to 2 years' experience in Billing, Collections, or Accounts Receivable Required
Licenses and Certifications
Other Must attend and pass proficiency test in the network’s Electronic Health Record system. Required
Responsibilities:Job Summary
The Reimbursement Specialist audits commercial and government payer reimbursements for patient accounts to ensure accurate payment for services according to contractual terms agreements and government regulations. Appeals underpaid accounts and communicate with payers until resolution.
HonorHealth offers a diverse benefits portfolio for our full-time and part-time team members designed to help you and your family live your best lives. Visit honorhealth.com/benefits to learn more.
Join us. Let’s go beyond expectations and transform healthcare together.
HonorHealth is one of Arizona’s largest nonprofit healthcare systems, serving a population of five million people in the greater Phoenix metropolitan area. The comprehensive network encompasses six acute-care hospitals, an extensive medical group with primary, specialty and urgent care services, a cancer care network, outpatient surgery centers, clinical research, medical education, a foundation, an accountable care organization, community services and more. With nearly 15,000 team members, 3,700 affiliated providers and close to 2,000 volunteers dedicated to providing high quality care, HonorHealth strives to go beyond the expectations of a traditional healthcare system to improve the health and well-being of communities across Arizona. Learn more at HonorHealth.com.Qualifications:Education
High School Diploma or GED Required
Experience
1 to 2 years' experience in Billing, Collections, or Accounts Receivable Required
Licenses and Certifications
Other Must attend and pass proficiency test in the network’s Electronic Health Record system. Required
Responsibilities:Job Summary
The Reimbursement Specialist audits commercial and government payer reimbursements for patient accounts to ensure accurate payment for services according to contractual terms agreements and government regulations. Appeals underpaid accounts and communicate with payers until resolution.
- Audits commercial and government payer reimbursements for patient accounts to ensure accurate payment for services.
Reviews payer contracts for reimbursement requirements and rates.
Ensures that all activity and transactions are clearly and concisely documented in accordance with established guidelines.
Adheres to Patient Accounting Policies and Procedures as evidenced by monthly audit; Maintain quality assurance and productivity scores as determined by Leadership.
Researches and processes credit balances and refunds following payer coordination of benefits, contract terms, and/or statutes as defined in the Policy & Procedure - Interprets data processing reports and applies the information as needed for daily departmental productivity.
Responds to inquiries timely:
WQ’s, phone inquiries and correspondence will be responded to within the established guidelines.
Client/requester will be informed of any delays or problems encountered. - Appeals underpaid accounts with payers and follows-up on accounts through resolution.
Works and documents patient accounts according to Payment Review guidelines.
Maintains master log of underpaid accounts for tracking purposes and updates log in a timely manner. - Provides feedback and support to Manager and various departments regarding contracting and operational issues in a timely manner.
Communicates issues and provides supporting documentation when necessary regarding contracts, payers, the contract modeling system, and all patient accounting errors. - Participates in training other staff members on reconciliation techniques and other aspects of the position. Maintains current knowledge of regulatory billing requirements for all assigned payers as directed by Leadership. Attends in-service/continued education. Performs other related duties as assigned or requested
Source : HonorHealth
