Reimbursement Counselor

Kelly Services is currently seeking Reimbursement Counselors for our client in Fort Mill, SC! Ideal candidates will have healthcare or pharmacy claims experience!

Start Date: 2/13/2017

Hours: 8:30a-5:30p

As a Reimbursement Counselor you will be responsible for accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and/or refunds, until accounts receivable issues are properly resolved. Collecting and reviewing all patient insurance benefit information. Providing assistance to physician office staff and patients to complete and submit all necessary insurance forms and program applications. Completing and submitting all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third party payors. Researching and resolving any electronic claim denials. Researching and resolving any claim denials or underpayment of claims.

Additional Job Duties:

Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods. Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; escalates complaints accordingly. Maintains frequent phone contact with provider representatives, third party customer service representatives, pharmacy staff, and case managers. Reports any reimbursement trends/delays to supervisor e.g. billing denials, claim denials, pricing errors, payments, etc. Processes any necessary insurance/patient correspondence. Provides all necessary documentation required to expedite payments. This includes demographic, authorization/referrals, National Provider Identification NPI number, and referring physicians. Coordinates with inter-departmental associates to obtain appropriate medical records as they relate to the reimbursement process. Maintains confidentiality in regards to patient account status and the financial affairs of clinic/corporation. Communicates effectively to payors and/or claims clearinghouse to ensure accurate and timely electronically filed claims. Works on problems of moderate scope where analysis of data requires a review of a variety of factors. Exercises judgment within defined standard operating procedures to determine appropriate action.

Job Requirements:

High School Diploma/GED

General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred.

Global understanding of commercial and government payers preferred.

Ability to proficiently use Microsoft Excel, Outlook and Word.

All your information is kept confidential as per EEO standards.

Why is this a great opportunity? The answer is simple…working at our client is more than a job; it’s a career. The opportunities are diverse whether you are right at the start of your career or whether you are looking for new challenges this is the job for you, so be quick and apply now!