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IV/Equipment Reimbursement Specialist

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Administrative/Clerical
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065882 Requisition #
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http://deptwebs2/php/VisualIdentity/images/PremierHealth.jpgIV/Equipment Reimbursement Specialist

Position information

              

Title: IV/Equipment Reimbursement Specialist

Facility: Fidelity Health Care                          

Job Reports to: Sr. Manager Patient Accounting                       

 

Premier Health Mission, Vision, and Values

 

The Premier Health Mission

We will build healthier communities with others who share our commitment to provide high-quality, cost-competitive health care services.

 

The Premier Health Vision

Patients, physicians, and employees will choose Premier Health over any other health care provider in Southwestern Ohio. We will earn their choice, and grow our market leadership by anticipating their needs and exceeding their expectations.

 

§  Patients and their families will choose us for our quality outcomes and compassionate care at a competitive price.

§  Physicians will choose us as collaborative partners for our easy, efficient practice environment and with a shared passion for high-quality medical outcomes.

§  Our employees will choose us as a great place to work, learn and build a career.

 

The Premier Health Values

§  RESPECT each person’s dignity.

§  Act with INTEGRITY to do the right thing in all aspects of our responsibilities.

§  Serve with COMPASSION that embraces each individual’s concerns and hopes.

§  Commit to EXCELLENCE as measured to the highest level of performance.

 

 

Position Summary

General Summary/Responsibilities:

The IV/Equipment Reimbursement Specialist manages accounts as assigned.  He or she processes and monitors accounts and collections.  He or she must maintain good customer service with patient or payer, interface with office staff, and perform other duties as assigned.

 

DIMENSIONS:

Responsible for approximately 10-50 accounts per day.

Scope/Span of Control: N/A

 

Supervisory Responsibilities (if applicable)

 

Supervises FTEs:   No

Number of FTEs Supervised: N/A

Exercises full management authority including performance reviews, discipline, termination and personnel hiring No

 

Fiscal Responsibilities (if applicable)

Annual Revenue in Dollars: N/A

Annual Expense in Dollars: N/A

Financial Accountability:  N/A         

 

 

Population Served

 

               Age of Population Served - Choose all that apply

                              Infant (birth – less than 1 year)

                              Pediatric/Adolescent (1 – less than 18 years)

                              Adult (18 – 64 years)

                              Geriatric (65 years & older)

All Age Groups (Birth & Above)

Not Applicable


Qualifications

 

Education

 

Minimum Level of Education Required: High School completion / GED

                                            

Additional requirements:

§  Type of degree: N/A

§  Area of study or major: N/A

§  Preferred educational qualifications: N/A

§  Position specific testing requirement: N/A

 

Licensure/Certification/Registration

 

§  N/A

 

Experience

 

Minimum Level of Experience Required: 1 - 3  years of job-related experience

Prior job title or occupational experience: Previous account billing and/or collection experience required.

Prior specific functional responsibilities: N/A

Preferred experience: Experience with medical terminology as well as 5-10 years’ experience in Medicare, Medicaid and third party billing procedures or equivalent is desired.

Other experience requirements: N/A

 

 

Knowledge/Skills

 

§  Must have good organization skills and work well with others.

§  Computer skills preferred.

§  Must be able to work independently.

 

Physical Requirements & Working Conditions

 

Physical Requirements:

Pulling

2 - Occasionally (11% - 40%)

Standing

2 - Occasionally (11% - 40%)

Other sounds

1 - Rarely (0% - 10%)

Twisting

2 - Occasionally (11% - 40%)

Reaching

2 - Occasionally (11% - 40%)

Visual Acuity Near

3 - Frequently (41% - 75%)

Walking

2 - Occasionally (11% - 40%)

Manual Dexterity

2 - Occasionally (11% - 40%)

Visual Acuity Far

2 - Occasionally (11% - 40%)

Sitting

4 - Consistently (76% - 100%)

Use both hands

3 - Frequently (41% - 75%)

Vision Color

2 - Occasionally (11% - 40%)

Pushing

1 - Rarely (0% - 10%)

Talking

3 - Frequently (41% - 75%)

Concentrating

4 - Consistently (76% - 100%)

Climbing

1 - Rarely (0% - 10%)

Lifting <10 pounds

2 - Occasionally (11% - 40%)

Interpersonal Skills

3 - Frequently (41% - 75%)

Stooping

2 - Occasionally (11% - 40%)

Lifting >10 pounds

1 - Rarely (0% - 10%)

Reading

3 - Frequently (41% - 75%)

Kneeling

2 - Occasionally (11% - 40%)

Normal hearing both ears

3 - Frequently (41% - 75%)

Thinking

4 - Consistently (76% - 100%)

Working Conditions:        

 Working Conditions:



1.      General office environment.

2.      Climate controlled environment.

3.      May work some evenings and weekend hours to complete projects or meet the needs of the         department.

4.      May be required to work overtime as defined by the needs of the department.

 

Organizational Standards

 

§  Coordinates billing process for assigned accounts.

§  Reviews and collects assigned accounts for payments.

§  Responsible for understanding reimbursement guidelines and associated benefits to ensure maximum allowance is realized and collected.

§  Maintains customer service with internal and external customers.

§  Monitor and track documentation needed for reimbursement to assure completion within payer guidelines.

 

Essential Duties & Functions

Essential Duties & Functions:

 

The IV/Equipment Reimbursement Specialist works from the accounts receivable (A/R) aging report on oldest outstanding claims, makes calls to appropriate payer to determine status of payment, works with insurance company regarding settlement and adjustment payments, resubmits claims as necessary for payment or resubmits additional information for review and payment, and is responsible for keeping documentation on follow-up made.  He/she must collect and review documentation needed for billing these accounts to the appropriate payer.  They must confirm data is accurate for reimbursement.  He/she must also track prior authorizations needed for reimbursement.

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