Medical Reimbursement Specialist, Robert Half

Medical Reimbursement Specialist

Robert Half

Location:

United States, Princeton

Category:

Finance

Contract Type:

Not provided

Salary:

Not provided

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Job Description:

We are in search of a Medical Reimbursement Specialist to join our team. Stationed in Princeton, New Jersey, you will be instrumental in tackling a backlog of aged medical claims and refining our reimbursement process. This role offers a long-term contract employment opportunity in the medical industry, where you will be tasked with tasks such as claims processing, denial management, payer follow-ups, and appeals.

Job Responsibility:

Analyze and categorize outstanding claims based on payer, denial reason, and claim value
Investigate and take corrective action on unpaid, denied, or underpaid claims
Collaborate with internal teams to obtain missing documentation and expedite claim resubmission
Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization
Submit corrected claims and formal appeals as required
Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary
Maintain comprehensive records of all payer interactions
Identify the root causes of denials and implement best practices to prevent future issues
Suggest changes to workflow to enhance claim submission accuracy and speed
Conduct training for in-house billing teams on claim recovery strategies

Requirements:

Minimum of 3 years of experience in a similar role
Proficient in benefit functions
Demonstrated expertise in billing functions
Experience in claim administration
Familiarity with collection processes
Ability to handle and resolve medical denials
Comprehensive knowledge of Medicare

What we offer:

medical, vision, dental, and life and disability insurance
eligibility to enroll in company 401(k) plan

Additional Information:

Job Posted:

March 25, 2025

Employment Type:

Fulltime

Work Type:

On-site work

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