Patient Financial Services Reimbursement Specialist I

Title: Patient Financial Services Reimbursement Specialist I - Full Time

Location: Hybrid Remote

Department: Professional & Corporate

Job Description:

Full-Time: Monday-Friday 8:00am-4:30pm. Hybrid-Remote. 

Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State’s largest private employer with over 104,000 employees — including members of Northwell Health Physician Partners — who are working to change health care for the better.

Summary:

Coordinates and monitors all aspects of Patient Financial Services daily functions, including billing compliance and accounts receivable functions. Responsible for the assigned areas claims submission, payment application, denial management, and account follow-up to ensure optimal reimbursement.

Responsibilities:

1. Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up. 2. Confirms electronic and hard-copy billing of any delinquent claims. Rebills and follow-ups of all delinquent claims. 3. Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries. 4. Advises other areas of updated insurance information and claim denials, i.e., registration. 5. Follows through with education of rules and regulations in the managed care system, as well as State & Federal guidelines. 6. Adjusts account balances to specific account needs. 7. Maintains Contract Management reporting (i.e., payment errors, carve out billings) and updates any information as needed or requested by supervisor. 8. Responsible for reviewing and resolving patient/insurance credit/debit balances and ensure proper communication is delivered to the patient. 9. Adheres to all policies and procedures related to federal, state and department compliance for the position. 10. Maintains and Model the Organizations values. 11. Demonstrates regular, reliable and predictable attendance. 12. Performs other duties as required.

Education Skills Experience:

• Required: High School Diploma or equivalent.
  Required: Data entry and customer service experience required. 
• Minimum Experience: six months.
• Desired: Experience in billing and collections or Medical Office/Healthcare experience preferred.

Working Conditions:

• Manual: significant manual skills/motor coord & finger dexterity
• Occupational: Little or no potential for occupational risk
• Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Org Unit: 1785
Department: Patient Accounting
Exempt: No
Salary Range: $19.54 - $29.00 Hourly