A career with Bronson opens up new worlds. Cutting-edge
technologies, clinical expertise and business innovations combined
with individual human care and compassion are all a part of the
BHG Bronson Healthcare Group
Reimbursement Specialist- Govt Programs
Performs duties necessary to facilitate payment from third party
payers. This includes correct billing, statusing and collection
from third parties, posting third party payments (if applicable),
computing correct reimbursement, processing incoming and outgoing
correspondence, and maintaining a working knowledge of current
contracts and government regulations for multiple entities.
Employees providing direct patient care must demonstrate
competencies specific to the population served.
High school diploma or general education degree (GED) required.
Associate's degree in business or Finance; or equivalent experience
in Hospital or Professional billing. Successfully pass EUPA's for
all Epic applications associated with position within the first 90
days in the position Strong computer and general office equipment
knowledge required. Knowledge of medical terminology, ICD-10 and
CPT-4 coding, National Billing forms, third-party payers, managed
care, reimbursement and regulatory compliance preferred. Ability to
type 45 words per minute is necessary. Must be an effective
communicator with patients, customers and co-workers. Must be able
to quickly analyze communication style based on nature and approach
of verbal inquiry. Work which produces very high levels of
mental/visual fatigue, e.g. CRT work between 70 and 90 percent of
the time, and work involving extremely close tolerances and
considerable hand/eye coordination for sustained periods of time.
The job produces some physical demands. Typical of jobs that
include regular walking, standing, stooping, bending, sitting, and
some lifting of light weight objects. Accountable for ensuring
claims are compliant with all payer specifications; State, Federal
and HIPAA regulations. Resolves billing issues up front to promote
better reimbursement, reduce outstanding revenue and time spent on
working rejections or additional claim follow up. Prepares
documentation to maximize reimbursement. Analyze assignment of all
CPT-4, ICD-10, UB04, HCFA 1500 and charges for accuracy and to
maximize reimbursement from third party payers Critically analyze
and process third party and internal information requests and
rejections in an effort to resolve accounts receivable. Critically
analyze and process documents for resolution of third party
liabilities, outstanding credits and un-billed accounts. Make all
necessary posting, adjustments and refunds to accounts and critique
contractual allowances and other arrangements. Responsible for
complete understanding and application of current contracts and
governmental regulations including referrals for legal intervention
for multiple entities. Proficient in the revenue cycle process via
multiple computer systems including but not limited to: Internal
systems: STAR, EC2000, EPIC, SSI, GLMI Home Health Billing system
and External systems such as payer claims and eligibility systems.
Verifies insurance eligibility using automated on-line systems.
Scheduled Weekly Hours
1205 Pt Acctg - Govt Programs (BHG)
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