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Reimbursement Specialist

Company: Halifax Hospital Medical Center
Location: Daytona Beach
Posted on: January 9, 2022

Job Description:

Halifax Health is seeking a Reimbursement Specialist for the PBFS Administration Department.

The Reimbursement Specialist is responsible for all aspects of remittance posting while maintaining absolute accuracy for daily balancing. This individual plays an active role in the Revenue Cycle by accurately applying payments, adjustments and remittance advice codes, performing analysis for contract rule validation and tracking and trending for process improvement. Keeps management apprised to any issues related to remittance and payment posting.

Job Qualifications:
Associates Degree in Accounting, Business Administration, Finance or at least two (2) years in a related field which can be substituted for a degree.Preferred minimum of two (2) years of healthcare experience in the area of reimbursement methodologies including managed care contracts, Medicaid and Medicare. Preferred knowledge of electronic remittance posting, interpretation of explanation of benefits, cash applications and batch posting processes.Preferred knowledge in third party billing and collections in a hospital setting.Excellent analytical, communication and organizational skills with strong attention to detail. Self-starter with the ability to work with minimal supervision.Proficient PC skills including Microsoft Word and Excel.Must be able to function and meet deadlines under stressful conditions and prioritize work flow.

Job Duties and Responsibilities:
Timely and accurate posting, adjusting and reconciling of funds received via lockbox payments, Electronic Funds Transfers and mail with posting accuracy of 99% or greater.Forwards potential third party or patient refunds to the Refund Specialist based on credit balances created from payments and/or adjustments posted to patients accounts.Responds to system tasks in a timely mannerPrepares daily reconciliation of cash posting to Accounting DepartmentApplies payroll deductions within 48 hours of receipt.Applies payments and adjustments not completed by the electronic remittance system.Prepares remote bank deposits and processes credit card transactions daily with 100% accuracy.Correctly identifies remittance codes and applies them to individual patients accounts as received by insurance companies. Validate, track and trend remittance codes for process improvement.Correctly identifies underpaid claims in accordance with hospital insurance contracts by applying underpayment codes correctly to patients accounts based off information received by insurance companies.Post insurance payments to the correct insurance plans as identified by hospital contracts. Updates patient accounts with corrected insurance plans and forwards to registration areas as identified at time of posting.Performs research related to unidentified payments received to determine the appropriate accounts for posting.Perform daily reconciliation process and procedure to ensure accuracy to daily postings.Contributes to effective working relationships by demonstrating a positive and helpful attitude in relationship with co-workers.Maintains privacy strictly adhering to HIPAA guidelines.Performs other duties as assigned

About Us:
Halifax HealthRecognized by The Joint Commission as a Top Performer on Key Quality Measures, Halifax Health serves Volusia and Flagler counties, providing a continuum of healthcare services through a network of organizations including a tertiary hospital, community hospital, psychiatric services, a cancer treatment center with four outreach locations, the areas largest hospice, a center for inpatient rehabilitation, primary care walk-in clinics, a walk-in clinic specializing in womens health, two community clinics, three childrens medical practices, a home healthcare agency, and an exclusive provider organization. Halifax Health offers the areas only Level II Trauma Center, Comprehensive Stroke Center, Pediatric Intensive Care Unit, Pediatric Emergency Department, Child and Adolescent Behavioral Services, complete Neurosurgical Services, OB Emergency Department and Level II Neonatal Intensive Care Unit that cares for babies born as early as 28 weeks. For more information, visit

Keywords: Halifax Hospital Medical Center, Daytona Beach , Reimbursement Specialist, Other , Daytona Beach, Florida

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