Our Reimbursement Specialist job description includes the responsibilities, duties, skills, education, qualifications, and experience.
About the Reimbursement Specialist role
A Reimbursement Specialist is responsible for processing, auditing, and verifying healthcare claims to ensure that all payments are accurate and appropriate according to the insurance company's guidelines. This role requires knowledge of medical billing and coding, as well as the ability to accurately interpret and report the results of audits. The Reimbursement Specialist must be detail-oriented and organized, with strong customer service and problem-solving skills.
Role Purpose
The purpose of a Reimbursement Specialist is to process and manage reimbursement requests for an organization. This may include verifying eligibility and documentation, entering requests into an accounting system, and disbursing payments to claimants. Reimbursement Specialists ensure that the organization's policies and procedures are followed and that all reimbursements comply with applicable laws and regulations. They also provide administrative support, including tracking and filing records, responding to inquiries, and maintaining accurate databases.
Reimbursement Specialist Summary
A Reimbursement Specialist is responsible for processing and managing reimbursement requests from employees and customers. The Reimbursement Specialist must have strong organizational and communication skills in order to ensure that all reimbursements are processed accurately and efficiently. They must also be knowledgeable in relevant laws and regulations regarding reimbursements and be prepared to research and resolve any discrepancies or issues that may arise. Responsibilities of a Reimbursement Specialist include but are not limited to: verifying and approving reimbursement requests, preparing and submitting reimbursement claims, collecting and organizing supporting documentation, maintaining accurate records, and responding to inquiries regarding submitted reimbursements.
Reimbursement Specialist Duties
- Provide assistance with claims processing
- Investigate and resolve customer inquiries
- Ensure claims are accurate and in compliance with applicable laws
- Prepare and submit reports to management
- Provide advice on reimbursement policies and procedures
Reimbursement Specialist Skills
- Proficient in accounting principles
- Ability to read and interpret insurance policies
- Excellent customer service skills
- Ability to analyze information and make decisions
- Knowledge of medical coding and billing
- Proficient in Microsoft Office applications
Reimbursement Specialist Requirements
- Bachelor's degree in accounting, finance, or related field
- Strong knowledge of applicable laws and regulations related to reimbursement
- Proficient in the use of Microsoft Office Suite
Personal Traits
- Excellent organizational skills
- Strong attention to detail
- Ability to work independently
- Excellent communication skills
- Knowledge of relevant software