Third Party Insurance Reimbursement Specialist

• Continuous follow-up with attorneys and liability carriers on settlement status.

• Makes recommendations to client to continue to pursue liability or to bill the debtor’s health insurance.

• Negotiates when necessary to ensure greatest recovery for our client.

• Calculates pro-rata share.

• Document all activity in CUBS and updates statuses on accounts according to department guidelines.

• Maintain WIP according to departmental guidelines.

• Maintain production and quality assurance standards according to department guidelines.

• Meets or exceeds pre-determined monthly collection goals.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required.
 

• Knowledge of Third-Party collections and principles
• Understanding of Hospital Receivables
• Understanding of Health Insurance billing and collections
• Ability to work in fast-paced, stressful environment
• Posses excellent written and verbal communication skills
• Posses excellent analytical skills
• Posses negotiation skills

•  Minimum education:  High School Diploma or equivalent.
• 1+ years billing/collection experience in health environment.

LANGUAGE SKILLS:        

• Exceptional written and oral communication skills. Bilingual a plus but not required.

 
MATHEMATICAL SKILLS:        

• Ability to add, subtract, multiply and divide in all units of measure, using whole numbers, common fractions and decimals.

REASONING ABILITY:

•     Must be able to make sound decisions based on facts.

PHYSICAL DEMANDS :

• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

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