POSITION PURPOSE:

The Reimbursement Specialist's core responsibility is timely and accurate review and resolution of insurance denials. The position is responsible for both The Orthopedic Center of Illinois and its partner the Orthopedic Surgery Center of Illinois. The successful candidate will use his/her coding and billing guidelines skills to investigate, follow up and resolve coding and billing errors. The reimbursement specialist is also responsible for posting EOB transactions and recognizing claim payment discrepancies regarding payer contracted rates.

MAJOR TASKS, DUTIES AND RESPONSIBILITIES:

1. Recognize claim denials (insufficient payments and/or denied charges), working towards resolution.
   1. Be familiar with practice contracts with insurance companies.
   2. Collaborate with coding specialists to resolve coding-based denials.
   3. Prepare and submit appeals and corrected claims within timely filing limits of each payer.
2. Write off uncollectible claims within the guidelines set by OCI.
3. Enter appropriate account notes to reflect problems identified and action taken.
4. Maintain proper documentation of transactions.
5. Maintain patient confidentiality; comply with the HIPAA guidelines established by the practice.
6. Maintain knowledge of practice management and other software as it relates to job functions.
7. Other miscellaneous duties as assigned.

KNOWLEDGE AND SKILL REQUIREMENTS:

1. High School Diploma required.
2. Minimum of 2 years' experience in a medical office required.
3. Must be able to work in a rapidly changing environment to meet deadlines, while paying close attention to detail.
4. Will be working cooperatively in a team-based setting.
5. Basic level of skill in Microsoft products such as Word and Excel.

Paid Holidays

Paid Vacation

Paid Sick Time

Monday - Friday Work Schedule

Medical, Dental, Vision, Life and other benefits

401K participation with a 6% match