What are the responsibilities and job description for the Payer Reimbursement Specialist Hybrid position at Private Label Staff?
Job Description
Job Description
Salary : Job Summary
The Accounts Receivable Specialist is responsible for managing insurance claims, billing, and order processing to support efficient revenue cycle operations. This role ensures accurate tasking across internal systems, timely claim resolution, and compliance with insurance and regulatory guidelines.
Key Responsibilities
- Task orders across internal systems such as Salesforce, Brightree, and Oracle.
- Process and submit insurance claims for DME respiratory equipment and services.
- Monitor and maintain patient order queues to ensure timely claim processing.
- Manage and resolve claim denials through appeals and follow-ups.
- Communicate with insurance companies to verify coverage, address billing discrepancies, and secure reimbursements.
- Reconcile accounts receivable balances and generate AR reports.
- Ensure compliance with Medicare LCD requirements, payer-specific guidelines, and other regulatory standards.
- Collaborate with internal teams to resolve documentation or authorization issues.
- Maintain accurate and HIPAA-compliant patient and financial records.
- Identify and recommend workflow improvements to enhance efficiency.
Knowledge, Skills, and Abilities
Qualifications
