DT Reimbursement Specialist

  • Garden Grove, CA, USA
  • Contract

Company Description

Here at CiNQ Recruitment, we believe in finding the right fit, for you and our clients. Whether you seek long-term employment solutions for your business or your next career move, we understand the importance of individual and business needs. With over 30 years of successful staffing and recruiting experience, we excel at providing passive candidates with the right skills and cultural fit for specialized positions. Here is the opportunity to work with an exciting pharmaceutical company.

Job Description

Position Summary: 

Perform duties to process medical billing and PBM and medical collections with focus on accuracy, timeliness, and adherence to process, to reduce denial rate, DSO, and bad debt. To recognize additional revenue opportunities, and improve in collection rates, while working within the limits of standard or accepted practice.


Essential Functions:

• Review patient files for completeness and accuracy, identify and audit claims, ensure all revenue opportunities are included, and complete and submit billing, primary and secondary, to payers for reimbursement, via paper bills and clearinghouse submittals.

• Review documents received including Explanations of Benefits (EOB), Remittance Advices (RAs) and other documents indicating denials or claims acceptance. Identify reasons for denials, take required corrective action, and take ownership of claims through to timely, successful collection.

• Analyze denials, identify trends and recommend process improvement opportunities that will result in DSO reduction, superior collection rate and intervals, reduced bad debt, and simplified processes that are responsive to the requirements of specific payers.

• Review claims with outstanding balances and identifies actions to successfully collect revenues. Follow up with insurers and patients to collect outstanding balances in an environment of world-class customer service focused on building enduring customer and business relationships.

• Document case activity, communications, and correspondence in computer systems to ensure completeness and accuracy of account activity and the actions taken to resolve outstanding claims issues. Schedule follow-ups in required intervals.

• Utilize Payer Portals via the internet for claim disposition.

• Contribute medical billing expertise to the design of training and knowledge transfer programs, materials, policies, and procedures to improve the efficiency and effectiveness of the Revenue Cycle Management team.

• Assist with the processing on online adjudication of collection issues and nurse billing as assigned.


Education/Experience Requirements:

• High School Diploma or equivalent and additional specialized training in medical billing and/or collections.

• Minimum 2 years of medical billing and/or collections experience.

• Coding Course Certification is highly preferred.

Additional Information

All your information will be kept confidential according to EEO guidelines.

PAY RATE: $18-$22/HR

SHIFT: 7 AM - 3:30 PM

*3-4 Month Contract*