Reimbursement Specialist

General Summary:

The Reimbursement Specialist performs a variety of accounting-related functions related to reimbursement, and billing.

Position reports to: Accounting/Billing Supervisor

Essential Functions:

1. Posts third party and other billing payments received.
2. Follows up and resubmits rejected and pended third party billings.
3. Assists in completion of provider enrollment forms for public and private insurances.
4. Assist in obtaining prior authorizations.
5. Gathers initial demographic and financial information to conduct ability to pay (ATP) determinations.
6. Provides and reviews annual ability to pay redeterminations.
7. Assist in generating payment plans for delinquent accounts.
8. Generate reports for staff or providers as needed.
9. Participates in agency committees as directed.

Other Functions:

1. Entry and maintenance of direct run locations.
2. Maintain and update rate schedules as needed in EMR.
3. Provide support to Accounts Payable, Claim Adjudication, and CCBHC Specialists as necessary.
4. Other duties as assigned in a positive, cooperative manner
5. Lapeer County Community Mental Health embraces an employment environment that promotes recovery and discovery, a person-centered approach to treatment/services, and cultural competence.  An employee with this or any position is expected to support the employment environment.

Qualifications

Employment Qualifications

Education:  High school graduation or equivalent.  Advanced course work in accounting or computer skills preferred.

Experience: 

1. One year experience working in a related environment. 
2. Knowledge and experience in Microsoft environment (Word, Excel, Outlook, Access)
3. Prefer experience and training in billing or accounting related services.