Reimbursement Specialist
National Seating & Mobility
Summary
The Reimbursement Specialist supports the Reimbursement team by identifying and correcting claims submission/payment errors. The Reimbursement Specialist is responsible for the accurate and timely follow-up of unpaid claims, by assigned payers and defined aging criteria to meet or exceed collection targets and minimize write-offs. This position ensures proper reimbursement was received according to payer contracts and fee schedules, correcting billing issues, and billing secondary claims.
Job description
Duties and Responsibilities / Essential Functions
- Performs timely and accurate follow-up on claims to payers and patients following prescribed policies and procedures.
- Responsible for preparing and submitting timely and accurate rebilled claims and initial billed secondary/tertiary claims to payers following prescribed policies and procedures.
- Enters certain demographic data into the billing and collections software following prescribed policies and procedures.
- Generates claims for both electronic and/or hard-copy submission.
- Generates Missing Information Requests (MIR) following prescribed policies and procedures.
- Identifies variances between booked revenue and expected reimbursement to facilitate accurate reimbursement of claims as defined by contracts, and state and federal law.
- Identifies and reports violations of NSM Credit Policy.
- Participates in collecting and documenting payer specific claims processing rules, practices and guidelines to contribute to, and maintain, the currency and accuracy of payer requirements for NSM personnel.
- Complies with and supports department and organizational policies and procedures.
- Assumes other duties and responsibilities as assigned.
Required Education, Experience & Competencies
- High School Diploma or equivalency certificate.
- Experience in working with billing and collections software highly desirable. Knowledge of medical billing and insurance claim filing, communications skills.
- Proficient in Microsoft Excel, Word, and Outlook. Adobe Acrobat is a plus.
- Strong data entry skills- keyboarding/accuracy/speed.
- Working knowledge of Microsoft suite of products (i.e. Outlook, Word and Excel) and Adobe Acrobat.
Requirements
- High School Diploma or equivalency certificate
- Experience in working with billing and collections software highly desirable
- Knowledge of medical billing and insurance claim filing
- Communications skills
- Proficient in Microsoft Excel, Word, and Outlook
- Adobe Acrobat is a plus
- Strong data entry skills- keyboarding/accuracy/speed
- Working knowledge of Microsoft suite of products (i.e. Outlook, Word and Excel) and Adobe Acrobat
Benefits
- 401(k)
- Company paid Long Term Disability
- Tuition reimbursement
Company overview
National Seating & Mobility (NSM) is a leading provider of comprehensive mobility solutions and complex rehabilitation technology, specializing in custom seating and mobility systems for individuals with severe physical challenges. Founded in 1992 and headquartered in Franklin, Tennessee, the company offers 360-degree Complete Mobility Solutions that include customizing wheelchairs, installing chair lifts, and repairing mobility equipment. NSM serves a diverse clientele including children with birth defects such as Cerebral Palsy, Muscular Dystrophy, and Spina Bifida, as well as teens, adults, and seniors challenged with severe trauma, disease, and skeletal disorders. The company operates with a nationwide network of experienced professionals including master Assistive Technology Professionals (ATPs), compliance specialists, and clinical experts who navigate complex insurance regulations and state/federal laws to ensure proper equipment funding and delivery. NSM's mission focuses on empowering clients with independence and self-reliance through personalized mobility solutions, while maintaining strong relationships with healthcare providers and referral sources across the United States.