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Reimbursement Representative

U.S. Renal Care Plano Full-Time
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U.S. Renal Care is seeking a Reimbursement Representative for our dialysis facilities. The Reimbursement Representatives role is to file insurance claims and collect on accounts assigned in a timely and accurate manner.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

  • Reviews EOB/EOMB’s for proper reimbursement. 
  • Responsible for all collection activities on identified accounts.
  • Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner.
  • Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment.
  • Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed.  Provides insurance carriers with requested information to facilitate payment.
  • Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits.
  • Performs claim appeals as required.
  • Assists with credit balance resolution.
  • Completes re-bill request as necessary to facilitate timely and proper claims payment.
  • Follows up on unresolved account balances including RTP’s.
  • Prepares adjustment and write-off requests as necessary.
  • Performs other duties and responsibilities as required or assigned.
  • Monitors all contracts and single patient agreements to ensure that appropriate reimbursement is received.

 
EDUCATION and/or EXPERIENCE:
• High School diploma or GED required.
• Minimum of two years experience in health/medical billing and collections.

U.S. Renal Care is an Equal Opportunity Employer/Disabled/Veteran


 

Recommended skills

Appeals
Claims
Medicaid
Explanation Of Benefits (Eob)
Medicare
Collections
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Job ID: 192677

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U.S. Renal Care was founded in 2000 and now serves more than 6,500 patients in more than 100 dialysis facilities across the country. We have a unique business model, developing and operating dialysis centers in joint venture partnerships with leading local nephrologists.

At our core, we exist to serve our patients. In fact, we like to say that we are inspired by our patients. We do our best to provide compassionate care, where and when patients need it.

We wouldn’t be a leading dialysis provider without our leadership team. Each team member brings decades of healthcare and business experience to their roles.

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