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Medical Reimbursement Specialist Job in Greer, South Carolina

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Job Title: Medical Reimbursement Specialist

Required Experience:1 to 2 years
Preferred Experience:3 to 4 years
Location: Greer 29651, SC, US
Date Posted:10/29/2019

Job Title: Medical Reimbursement Specialist

Supervised by: Coordinator, Billing

Posting: External

Location: Greer, SC

Weekly Hours: Full-Time


Position Overview: Looking for a goal-oriented Medical Reimbursement Specialist who is highly accurate and motivated to provide financial, administrative, and clerical services and to ensure accuracy and efficiency of operations. This position is responsible for following up on unpaid claims, utilizing monthly aging reports, filing appeals when appropriate to obtain maximum reimbursement, verifying and submitting accurate corrected claims, and establishing strong relationships with patients, insurance representatives, and insurance companies.



·        Ensures all claims are processed and paid with a goal of zero errors. Verifies completeness and accuracy of all claims prior to submission. Utilizes clearinghouse to download electronic payments and process rejections.

·        Reads and interprets insurance explanation of benefits.

·        Timely follow up on insurance claim denials, exceptions or exclusions. Meets deadlines. Utilizes monthly aging reports to follow up on unpaid claims aged over 30 days.

·        Makes necessary arrangements for medical records requests, completion of additional information requests, ect. as requested by insurance companies. Submits appeals when appropriate for reimbursement.

·        Responds to inquiries from insurance companies, patients, and providers.

·        Regularly meets with Billing Coordinator to discuss and resolve reimbursement issues or billing obstacles. Participates in educational activities and attends monthly department meetings.

·        Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations; also conducts self in accordance with the Tribe employee handbook.

·        Actively demonstrates an overall desire to practice the Tribe Way through humility, and exemplify a servant’s attitude towards others in the department, company, and patient population. Works to maintain integrity and excellence in every area of the job description and show initiative towards others by practicing conscious leadership in the role.



High School Diploma or equivalent. Prefer experience in Medical Billing and Coding or Accounting; however, physician practice experience in lieu of education will also be considered.



·        Knowledge of medical billing/collection practices, basic medical coding, and third-party operating procedures and practices.

·        Knowledge of business office procedures including computer programs as well as the ability to operate a computer and basic office equipment. Well organized and detail-oriented

·        Ability to operate a multi-line telephone system

·        Skilled in patient communication with a pleasant and helpful manner as well as the ability to establish and maintain effective working relationships with patients, employees and the public


Environmental/Working Conditions:

Normal office environment. Occasional overtime may be required and/or hours may be shortened as business needs dictate.


Physical Demands:

Requires sitting and standing associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard. This description is intended to provide only basic guidelines for meeting job requirements. Working conditions, skills and responsibilities may change as needs evolve.


To apply please visit: www.tribe513.org

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