Reimbursement Rep in Plano, TX at DISYS

Date Posted: 2/16/2018

Job Snapshot

  • Employee Type:
    Full-Time
  • Location:
    Plano, TX
  • Job Type:
    Finance
  • Experience:
    At least 2 year(s)
  • Date Posted:
    2/16/2018

Job Description


BHJOB8895_106916  I have 4 Commercial Insurance Claims and 4 Government Insurance Claims (Medicare/Medicaid ) openings in the Plano Area.  If you have experience in both, we just need to let them know which one you are stronger in

Hours/Schedule(if training schedule include here) --- 8:00 AM --- 5:00 PM

?Must Haves for Claims Processor :

  • High School diploma or GED required
  • Minimum of two year’s experience in health/medical billing and collections
  • Reviews EOB/EOMB’s for proper reimbursement

Job Description for Claims Processor:

Responsible for contacting insurance payers and determining why a claim wasn’t paid and will run point on the appeals process for denied claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES for Claims Processor :

  • Reviews EOB/EOMB’s for proper reimbursement.
  • Responsible for all collection activities on identified accounts.
  • Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner.
  • Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment.
  • Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed.  Provides insurance carriers with requested information to facilitate payment.
  • Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits.
  • Performs claim appeals as required.
  • Assists with credit balance resolution.
  • Completes re-bill request as necessary to facilitate timely and proper claims payment.
  • Follows up on unresolved account balances including RTP’s.
  • Prepares adjustment and write-off requests as necessary.
  • Performs other duties and responsibilities as required or assigned.
  • Monitors all contracts and single patient agreements to ensure that appropriate reimbursement is received.

EDUCATION and/or EXPERIENCE for Claims Processor :

  • High School diploma or GED required.
  • Minimum of two years experience in health/medical billing and collections.

Digital Intelligence Systems, LLC. is an Equal Opportunity Employer, M/F/D/V. We do not discriminate against any employee or applicant because they inquired about, discussed, or disclosed compensation. Email recruitinghelp @ disys.com to contact us if you are an individual with a disability and require accommodation in the application process.