Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.
The Reimbursement Specialist is entrusted to set a positive tone for every customer. They also demonstrate the ability to be a self motivated, energetic person who can interact with third party payers in a courteous manner. The Reimbursement Specialist: coordinates the customers questions and serves as the communication for the CBO, in an attentive, courteous, and competent manner; serves as the liaison between patients and the insurance companies while demonstrating self-confidence, adaptability and personal initiative; maintains a positive attitude and remains calm under pressure.
Behaviors:
- As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.
Required Qualifications:
- High School education or GED
- Knowledge of computer keyboarding
- Good communication skills
- Good telephone technique
Preferred Qualifications:
- Knowledge of 3rd party payers (i.e., Medicaid, Medicare, Commercial)
- Medical Terminology and coding experience
Duties and Responsibilities:
- Responsible for filing insurance claims for all third party payers in a timely and accurate manner
- Ensures goals and objectives established with CBO Manager are attained
- Mail appropriate forms to payers and/or patients
- Posting all payments received from insurance and patients, timely and efficiently
- Coordinating billing and limited follow-up activity associated with the collection of patient accounts
- Stays informed of changes in billing procedures that impact process and /or reimbursement effectiveness
- Professional appearance
- Commitment to successful operation of the clinic billing office
- Maintain strict patient confidentiality
- Documents relative information on patients accounts as per CBO protocol
- Each employee is responsible for implementing SJRMC’s Service Standards into their daily work:
Safety, Courtesy, Effectiveness, and Stewardship
Physical Demands and Environmental Work Conditions:
- Lifting up to twenty-five (25) pounds is required
- Job is sedentary in nature and involves long periods of sitting
- Extensive computer keyboarding
- Posting involve communicating with clients/patients face to face, as well as on the phone