Reimbursement Representative

Responsibilities USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization. SUMMARY The Reimbursement Representative performs reconciliation and review of all outstanding Medicare/Commercial patient balances in accordance with US Renal Care reimbursement policies and procedures. Essential Duties and Responsibilities include the following. Other duties and tasks may be assigned. * Reviews EOB/EOMB's for proper reimbursement. * Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner. * Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment. * Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed. Provides insurance carriers with requested information to facilitate payment. * Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits. * Performs claim appeals as required. * Assists with credit balance resolution. * Completes re-bill request as necessary to facilitate timely and proper claims payment. * Follows up on unresolved account balances including RTP's. * Prepares adjustment and write-off requests as necessary. * Performs other duties and responsibilities as required or assigned. Qualifications Qualifications/Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements include: * High School diploma or GED require * At least two years of experience in a health/medical billing and collection office. * Ability to use copier, fax machine, printer, calculator and multi-line telephone * Must be proficient with computers with an understanding of medical billing software * Advanced knowledge of medical terminology as well as knowledge of government and private insurer rules and regulations. * Advanced knowledge of CPT, ICD-9 and HCPCS coding as well as in-depth knowledge of medical billing requirements * Working knowledge of Microsoft Outlook, Word and Excel * Ability to utilize the internet, specifically Medicare and Medicaid websites * Maintain confidentiality in regard to HIPAA rules and regulations, as well as private company matters Benefit Details All Full-Time employees are eligible for the following benefits: * Medical / Pharmacy * Dental * Vision * Voluntary benefits * 401k with employer match * Virtual Care * Life Insurance * Voluntary Benefits * PTO All Part Time employees are eligible for the following benefits: * 401k with employer match * PTO