Senior Medical Reimbursement Analyst

This is a fully remote position, open to applicants in Florida.

📋 Description

• Address outstanding high-dollar insurance balances through effective collections.

• Investigate unpaid, underpaid, and denied high-value insurance claims while adhering to contractual billing and payment guidelines.

• Manage accounts until charges are either settled or denied by the insurance provider, ensuring process efficiency and productivity levels are upheld.

• Implement reimbursement principles across billing, coding, recovery, and patient financial responsibility.

• Monitor high-dollar balances, identifying and reporting payer trends and issues to management and during huddle board discussions.

• Actively seek payment from payers for denied claims and underpayments via email, appeals, and various communication channels.

• Input patient demographics, guarantor, and coverage details into the Epic system.

• Execute retro adjudication, modify filing order, request adjustments or reversals, and refile claims as necessary.

• Resolve discrepancies while maintaining professional relationships with insurers and insured patients.

• Collaborate with revenue-cycle departments and participate in both internal and external meetings.

• Stay informed about changes in insurance policies and systems, payer plan standards, and contractual revisions.

• Apply balance adjustments and invoice guarantors for patient financial obligations when relevant.

⛳️ Requirements

• High school diploma.

• Minimum of 1 year of relevant experience.

🏝️ Benefits

• Competitive salary and performance-based incentives.

• Comprehensive health, dental, and vision insurance.

• Opportunities for professional development and career advancement.

• Flexible work hours and a supportive team environment.