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 a Reimbursement Specialist I responsible to 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. 
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. 
  • Processes overpayments within the guidelines of federal & state regulations, payer requirements, & hospital standard procedures. 
  • Receives & processes requests from patient families, insurance carriers, government entities, & other sources. Must provide appropriate requested information to ensure quality customer service & appropriate adjudication of claims. Compliant with Federal, state, & hospital regulations to ensure privacy is maintained in compliance with HIPAA.

Specific qualifications for the position include

  • H.S. Diploma,GED,or Equivalent (Minimum)
  • Associate's Degree (Preferred)
  • 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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