Agency:
Alternate Solutions Health Network
Our culture and people are what set us apart from other post-acute care providers. We’re dedicated to the growth and development of our team to set them up for success. We CARE for our patients like they are our own FAMILY.
Note: The Centers for Medicare & Medicaid Services (CMS), in collaboration with the Centers for Disease Control and Prevention (CDC), require COVID-19 vaccinations for all Medicare and Medicaid certified providers. Based on this regulation, all of our employees must be fully vaccinated or have a valid exemption.
The Reimbursement Specialist is responsible for all collection aspects for assigned payors and confirms eligibility for payor types. The Reimbursement Specialist ensures prompt payments and claim processing. Functions of this role performed timely and accurately, affect patient satisfaction, and quality outcomes. The Reimbursement Specialist complies with all legal, Medicaid & private insurance and company rules and regulations.
Schedule:
Monday - Friday, 8:15am - 5:00 pm in our office in Kettering, OH
Responsibilities:
• Collects and follows up on accounts for payment in full
• Sends all electronic and paper claim resubmissions or correct claims
• Makes recommendations to the Controller regarding difficult payors with regards to prompt payments, claims processing, and recognition of denial trends.
• Assists clients, their families and co-workers in understanding billing procedures and payment
• Corrects claims and rebills for payment
• Communicates with employees, clients and vendors in regards to services
• Proactively addresses billing challenges
• Understands and practices agency policies and procedures
• Continually improves practices
• Follows all legal rules and regulations
• Attends in-services, educational programs and meetings as necessary
• Other duties as assigned
Qualifications: • High school diploma or equivalent.
• An Associate’s degree or equivalent experience required.
• Billing and Health Care experience is preferred.
• Excellent oral and written communication skills.
• Proficiency in Microsoft Excel, Word, and Outlook.
• Detail oriented with ability to manage multiple responsibilities and ability to prioritize responsibilities. Demonstrate critical thinking and problem solving.
Kettering, OH
We’ll help you put your passion for patient care to work. Apply today!
This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee. Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.
We are an Equal Opportunity Employer.
Top Skills
What We Do
We’re building partnerships and transforming care. Alternate Solutions Health Network was founded in 1999 by David and Tessie Ganzsarto. We collaborate with health systems in joint venture partnerships to create a post-acute care solution, delivering efficient centralized operations and utilizing a best-in-class software platform.
Our company has been dedicated, since the very beginning, to transforming the quality of care for both our partners and our patients. Our partnerships are built upon four cornerstones for maximizing quality outcomes and financial performance: Growth, Profitability, Quality Outcomes & Satisfaction, Compliance.
By utilizing a centralized operational model we’re able to deliver the highest level of efficiency to our partners. Our model is uniquely suited for success in at-risk and value-based reimbursement models with payers, hospitals and other providers.
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