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The Medical Reimbursement/Billing Specialist will manage activities of the billing and receivable functions of NNHSC as well as maintaining filing system for third party patients, follow-up rejections and record payments and follows role assignments that are in alignment with the Patient Centered Medical Home Standards, and participate in all Patient Centered Medical Home efforts.
Transmission of billing for Medical, Behavioral Health, Optometry, Dental and Ancillary services
Download remittances from various insurances portal systems
Post manual and electronic payments into Practice Management system
Reconciliation of remittance vouchers against transmissions and EOB’s
Responsible for collecting, posting and managing account payments
Audit claims before processing for insurance reimbursement
Submit claims to Clearing House
Verifies over-payments, collecting data, making adjustments, reversals and clearing up any discrepancies
Manages rejected billing and re-submission of claims for Medicaid, Manage Care Organizations and third party insurances
Review delinquent accounts and perform various collection actions including contacting patients by phone, insurance carriers, correcting and resubmitting claims to other MCOs
Assists in responding to the requests for medical information from patients, doctors, insurance companies, attorneys, state and federal agencies by copying reports as needed
Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations
Other duties as assigned
Associate's degree and CBCS or equivalent certificationrequired. Bachelor's degree preferred.
Submit resume and cover letter to include salary expectation.
The Mission of Near North Health Service Corporation (NNHSC) is to provide access to high quality health care and to improve the health and well-being of the diverse populations and communities we serve. We are a culturally sensitive, patient centered community health center that empowers individuals through education and health prevention, regardless of one’s ability to pay.