Reimbursement Specialist III

Every day, Global Payments makes it possible for millions of people to move money between buyers and sellers using our payments solutions for credit, debit, prepaid and merchant services.  Our worldwide team helps over 3 million companies, more than 1,300 financial institutions and over 600 million cardholders grow with confidence and achieve amazing results.  We are driven by our passion for success and we are proud to deliver best-in-class payment technology and software solutions.  Join our dynamic team and make your mark on the payments technology landscape of tomorrow. 

AdvancedMD is hiring a Reimbursement Specialist. Reimbursement Specialists on the Premier Specialty Team focused, offer insightful expertise as it relates to their assigned client base. The associates on this team are assigned to one of three functional areas, Claim Management, Denial Management and Aged Unpaid Claim Follow up. These team members work directly with clients to identify, prioritize and manage strategic needs for an efficient service workflow for optimal A/R outcomes. Reimbursement Specialists will manage a broad array of projects in relation to claims resolution, including payer tracking, website access, claims status inquiries, and direct carrier contact. 
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RESPONSIBILITIES:

• Correct claims pre-submission for identified edits that will result in a claim denial or delay
• Follow up on denied and rejected claims as identified through carrier denials/rejections via software or EOBs
• Follow up on unpaid claims in an aged approach for final claim resolution
• Communicate payer requirements or updates to clients and leadership
• Proactively assist clients in identifying specific claim edits to avoid future claim denials
• Communicate effectively and proactively with clients to avoid escalation
• Track A/R progress and profitability of client accounts
• Identify and analyze reimbursement trends within the client office key
• Identify and communicate payer trends
• Mentor and train team members as directed by the supervisor
• Perform additional functions as directed by Leadership

QUALIFICATIONS REQUIRED:

5+ years of medical billing experience

PREFERRED QUALIFICATIONS: Preference will be given to candidates who have the following: 

• Knowledge of Medicare, Medicaid and commercial payors claims and appeals processing requirements
• Knowledge of ICD, CPT and HCPC coding, ability to ready EOB and ERA files
• Advanced understanding of CCI edits and carrier specific coding edits
• Advanced knowledge of AdvancedMD software
• Ability to maintain accurate client master file records
• Strong working knowledge of Windows, MS Word, Internet Explorer, Excel, and Outlook
• Must have a meaningful understanding of the Medical Billing Process and Industry Standards
• Ability to manage and fulfill client expectations independently by managing client questions, processes and escalations
• Excellent written and oral communication skills
• Proven track record or writing compelling appeals with favorable outcomes
• Excellent communication and organizational skills with a customer service focus
• Ability to prioritize effectively and handle shifting priorities professionally
• Knowledge of medical computerized billing and scheduling software systems
• Personal track record of being thorough, courteous and responsive in customer service
• Ability to communicate with various business contacts in a professional and courteous manner
• Self-starter with the ability to organize work for maximum efficiency and attention to quality
• Proven ability to meet deadlines in a fast-paced environment
• Ability to grasp new concepts and procedures quickly, with a desire to learn
• Ability to be a vital member of a large, developing team
• Ability to mentor team members and train effectively
• Ability to work independently without direction or assistance

Global Payments Inc. is an equal opportunity employer. Global Payments provides equal employment opportunities to all employees and applicants for employment without regard to race, color, religion, sex (including pregnancy), national origin, ancestry, age, marital status, sexual orientation, gender identity or expression, disability, veteran status, genetic information or any other basis protected by law. If you wish to request reasonable accommodations related to applying for employment or provide feedback about the accessibility of this website, please contact [email protected].