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Sr. Reimbursement Specialist

Sr. Reimbursement Specialist

Job ID 
2017-1632
Category 
Eligibility
Location 
US-CA-Anaheim

More information about this job:

About The Company:

MedData, a MEDNAX (NYSE: MD) company, is a technology-enabled services organization that improves financial outcomes for hospitals by enhancing the patient experience and expanding their access to healthcare. The MedData managed services program includes a range of patient access and communications, revenue cycle management, and consulting and analytics solutions for healthcare systems, including billing, coding, patient balances, eligibility and enrollment, third party liability, and mobile apps.
 
At MedData, we take great pride in our company, in each other, and in our 30+ year history of accomplishments and success. This pride is reflected in our everyday approach to working together. Each team member understands the importance of being part of a company that values their individual contributions and strives to help them achieve their personal goals as they work together to achieve the broader corporate goals. We believe that every team member contributes directly to MedData’s growth and success, and we are constantly searching for new talented, passionate and enthusiastic people who will take pride in being an integral part of our culture.

Job Description:

POSITION OVERVIEW:

The job is appeal and follow-up denied Medi-Cal claims until the accts are paid or resolved; initiate and follow through the process of hospital enrollment with Medicaid (out-of-state) payors; assist in TAR submission and follow-up, and update hospital systems and reconcile client reports on TAR assistance efforts.

 

ESSENTIAL JOB FUNCTIONS:  

  • Carry out Billing Appeals Service and similar service requests from client hospitals
  • File appeal or grievances for denied/underpaid claims and work the appeals dashboard for follow-up and documentation
  • Gather the required documents and submit hospital enrollment applications to out-of-state Medicaid payors
  • Work the provider enrollment dashboard to follow-up the enrollment applications until approved and the claims are ready for billing
  • Communicate closely and coordinate with the client hospitals with respect to the Medicaid enrollment process
  • Assist with the submission and follow-up of TARs/SARs, including resubmission of deferred TARs and appeal of non-clinical TAR denials
  • Update hospital systems on TAR responses, making sure the correct bills are dropped
  • Prepare reconciliations reports on SJHS TAR assistance efforts and closely coordinate with the business office to ensure success in billing and collections
  • Respond to other tasks assigned by the department manager

 

QUALIFICATIONS: 

  • High school graduate, preferably with 2 years college
  • At least 2 years’ experience with revenue cycle work in a hospital setting
  • Read, speak, write and understand the English language fluently
  • Keyboarding skills, at least 35 wpm
  • High-level analytical skills
  • Tenacious collector
  • Knowledge of hospital’s patient accounting systems (MediTech, ePic, Cerner, etc)
  • Intermediate knowledge of Excel, and other MS office applications
  • Dependable and highly detailed individual
  • Willing to learn new systems and functions
  • High commitment to customer service to our internal and external clients.
  • Possess a high level of integrity – must show good judgment and confidentiality at all times

 

This job description is to serve as a guide but no way is it to be considered a comprehensive list of task, duties and responsibilities that will be required by the employee.

 

To join our team of 2,000 employees and growing, please visit apply directly to this posting.


MedData is an equal opportunity employer.  IND123