Reimbursement Specialist I

Reimbursement Specialist I
In San Diego, California 92123

Job Description

Workway is a professional staffing firm, working with organizations across the country to place exceptional candidates. We are looking for two Reimbursement Specialist I's for their Patient Financial Services. The job seekers must have prior or current Medi-Cal billing experience, willing to work as required for a 8-13 week project and the schedule will be Mon. - Fri., 8:00 a.m. - 5:00 p.m.

Your specific duties will include:

  • Resolve all claim edits, stop bills, & account edits including late charges, charge errors, consecutive accounts, duplicate accounts, & claim errors in order to submit timely & accurate claims to government agencies, commercial payers, & other payers as assigned in accordance with federal, state, industry regulations & standards. Knowledge of HIPAA billing requirements to include claims (UB & 1500 current versions), & basic CPT coding, ICD 9/ICD10.
  • Ability to read & apply complex contractual arrangements to identify expected reimbursement to include fee schedules, per diems, high dollar stop loss, DRGs, APCs, & carve outs.
  • Review all denials/underpayments & take corrective action based upon national denial reason codes, remark codes & payer specific codes. Must understand payor-specific requirements & utilize payer websites, procedural billing manuals, & standard operating procedures.

Specific qualifications for the position include

  • Associate's Degree (Preferred)
  • H.S. Diploma,GED,or Equivalent (Minimum)
  • 2 Years of Experience (Minimum)
  • 3 Years of Experience (Preferred)

Let one of our recruiters assist you in finding and preparing for interviews with our clients. Whether you are interested in a direct hire, temp-to-hire, or temporary position, Workway can help you to put your best foot forward. Contact us today! 

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