Reimbursement Specialist - Healthcare jobs in Toledo, OH

Improving Lives Together

Magruder Hospital offers competitive wages with a comprehensive benefit package available to both full-time and part-time employees. We provide a full health plan and generous time off that includes Holidays, Vacation, Sick, Personal, and even your Birthday! Earn 2 weeks of vacation your first year and up to 3 weeks your third! Our culture and family friendly work environment truly set us apart- apply today for an opportunity to join our team and help serve this great community!

Bills insurance companies for all hospital and hospital employed provider bills; pursues collection of all claims until payment is made by insurance companies; and performs other work associated with the billing process.

• Secures needed medical documentation required or requested by third party insurances.
• Follows up with third party insurance carriers on unpaid claims until claims are paid or until only self-pay balances remain.
• Maintains worklist daily
• Responsible to timely preparation of input documents and submission to cash posting
• Keeps updated on all billing requirements and changes for third party payers.
• Maintains diagnosis follow-up procedure and working relationship with Health Information Coders.
• Post payments when needed.
• Assist with researching posting problems when needed.
• Complies with federal, state, and local legal requirements by studying existing and new legislation; anticipating legislation; enforcing adherence to requirements; advising management on needed actions; ensures compliance with Joint Commission and other external and internal regulatory agencies.
• Maintains the integrity of confidential patient information in accordance with HIPAA and hospital policy, including accessing, using and disclosing patient information relevant to the individual employee’s job duties. Also maintains confidentiality of other customer and hospital business affairs.
• Adheres to the standards of Magruder Hospital’s corporate compliance policies and seeks guidance and training when necessary to resolve questions about the policies. Reports violations in accordance with corporate compliance and organizational standards.
• Reports to work on time and as scheduled; Shows respect for co-workers by following established break times; Keeps personal conversations and telephone calls to a minimum.
• Travel is primarily local during the business day, although some out-of-area and overnight travel may be expected.
• Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

• High School Diploma or GED equivalent
• Knowledge in ICD and CPT coding
• Must be able to see, hear, respond and communicate efficiently to the customers, patients and to calls received. Must be able to interact efficiently with others.
• Must have the manual dexterity to use computer to determine proper accounts and be able to operate a calculator to run tapes.
• Must be detail oriented to research accounts to determine proper payment and verify correct adjustments for accounts.
• Must have the ability to deal with constant interruptions with poise, tact and professionalism, while maintaining a positive image for the hospital.

• Stress management skills
• Problem solving skills
• Participant in special workshops of training sessions in Medicare, Medicaid and non-government payers procedures to maintain a current, knowledgeable position relative to these procedures.

• 1 year hospital billing business office experience

Preferred:

• Associates Degree in Medical Billing and Coding or related field
• Knowledge of automated systems preferred

Magruder Hospital is an Equal Opportunity Employer and provides equal employment and advancement opportunities to all qualified applicants for employment without regard to race, color, religion, sex, sexual orientation, gender identify, national origin, veteran status, disability, or any other protected class under the law.

Magruder Hospital is a Tobacco and Drug Free Workplace. Any offer of employment will be contingent upon satisfactory completion of pre-employment drug screening, including screening for the presence of nicotine, satisfactory completion of background verification, and the results of a post-offer medical and physical examination.