A Reimbursement Coordinator ensures that the patients are charged accurately for the medical services provided to them. The most common work activities seen on the Reimbursement Coordinator Resume include the following – serving as a patient advocate for identifying reimbursement coverage options, identifying reimbursement options for the non-insured patients; recording and monitoring insurance authorizations to ensure payment compliance and treatment continuity; maintaining and analyzing data about cases that need reimbursement support; and working with treatment providers and insurance companies for obtaining payment authorizations.
To qualify for this role, generally, a registered nurse along with a state certification is needed. Extensive knowledge with Minimum data set is also required. Those who want to succeed in this role should also have the right personality qualities such as a methodical and precise work approach, record maintaining skills; proficiency in writing and speaking, and strong interaction skills.
Objective : Seeking a Reimbursement Coordinator position with an outstanding career opportunity that will offer a rewarding work environment along with a winning team that will fully utilize management skills.
Skills : Administration Skills, Microsoft Office, Coordinating Skills.
Description :
Coordinated all aspects of securing accounts to include eligibility, referral coordination, and expressing financial expectations using on-line systems, telephonic verification, and faxing, to update and verify patient demographic and payer information.
Documented and updated all registration and financial data in the Computer System.
Responsible for the correct identification and selection of appropriate insurance plan codes.
Responded to telephone inquiries related to billing, insurance requirements, and general services provided in different programs and locations.
Assumed responsibility for routing calls to appropriate individuals and departments.
Developed strategies to be effective and remained professional while coping with difficult customers and situations.
Obtained supporting documentation from both facilities and corporate employees to support medicare coinsurance to be filed on the cost report.
Experience
2-5 Years
Level
Junior
Education
AAS
Reimbursement Coordinator Resume
Summary : Over 3 years of Reimbursement Coordinator experience required, specifically related to account receivable and denials management. Primary liaison with payers (commercial, Medicare, Medicaid, etc.) with a primary focus on payer denials/rejections, claim appeals, and accounts receivable.
Submitted Hospital and Professional claims to Medicare, Medicaid, Commercial Insurance, Tricare, and self-pay.
Followed up on outstanding claims.
Maintained Logs for Cost Reports.
Completed and submitted Medicare Credit Balance reports.
Responsible for performing all job duties while adhering to HIPAA requirements.
Verified eligibility and durable medical equipment benefits of patient medical insurance.
Determined the authorization process and requirements of Payers.
Experience
10+ Years
Level
Senior
Education
High School Diploma
Reimbursement Coordinator Resume
Headline : As a Reimbursement Coordinator, responsible for Coordinating reimbursement assessments, including Medicare determinations, minimum data sets, and performing insurance reviews.
Skills : Effective teamwork, Process-oriented, Verbal Communication Skills.
Description :
Pre-registered and verified insurance eligibility and benefits prior to the initial appointment.
Determined appropriate and accurate coding that is in compliance with Federal, State, and other Insurance carriers.
Reviewed tp1, tp2, evaluations, charts, and productivity reports for completeness and accuracy for proper billing and reimbursement.
Assisted in training department associates on payer documentation requirements, billable CPT codes, diagnoses codes, and Icd9 codes.
Maintained contact with referring providers to obtain consultations, current referrals, physician signatures, and additional information as required.
Assisted the patient financial department in identifying and reporting payment trends, procedures, or diagnoses that are denied.
Experience
5-7 Years
Level
Executive
Education
Diploma
Reimbursement Coordinator Resume
Objective : Reimbursement Coordinator with 2+ years of experience in maintaining the Diagnosis List or Sheet in the electronic system. Responsible for Performing ICD coding as trained and in consultation with Nursing and Clinical Reimbursement Coordinator.
Skills : Proficient In Office Suite, Management Experience, Claims Processing.
Description :
Verified medical insurance coverage and home health eligibility for patients according to their plan's Limitations, Deductible, Co-insurance, and Co-pay.
Obtained prior authorizations, pre-certifications, and continuing service authorizations from insurance companies.
Managed all parts of the authorization process for payors with an approximate revenue of $1.23 million and backup payors with an approximate revenue of $1.1 million.
Coordinated and consulted with field staff and clinicians to ensure the correct number of visits got authorized.
Documented all activity done to a patient's account in the system.
Responded to patient inquires regarding insurance coverage and authorizations.
Reviewed patient accounts to determine completeness, identify and determine problems, and took appropriate corrective actions for resolution of errors or issues.
Experience
2-5 Years
Level
Junior
Education
High School Diploma
Reimbursement Coordinator Resume
Headline : Multifaceted, efficient, and reliable administrative professional with more than ten experience supporting executives, claims managers, and supervisors to improve internal operations. Proficient in all standard office software and web design programs, plus ACAS. Service-oriented and diversified skill sets covering administrative support, client relations, and customer service.
Skills : Billing, and Analytical thinking, Problem-solving Skills.
Description :
Directed and conducted educational meetings with insurance companies and physicians to market Positron Emission Tomography (P.E.T.) exams.
Scheduled patients and completed precertification for PET exams.
Reviewed patient records to ensure the proper diagnosis (ICD) and procedure (CPT) codes were submitted to the insurance companies.
Provided analytical, financial, accounting, and compliance support to the administration for the Department of Medical Imaging.
Provided a wide range of administrative duties within the department of Medical Imaging.
Marketed, analyzed, presented, and reported results of PET exam benefits nationwide.
Increased awareness and increased return on investments through successful marketing of PET exams, account payables, and account receivables.
Experience
5-7 Years
Level
Executive
Education
High School Diploma
Reimbursement Coordinator Resume
Headline : Provide high-quality coding, and revenue cycle management services in a remote environment for an organization that promotes professional growth.
Skills : Administration Skills, Microsoft Office, Coordinating Skills.
Description :
Complied with contractual filing and appeals processes at all times.
Supported the objectives of the Reimbursement Operations Team Lead/Manager.
Answered inquires and requests regarding insurance issues.
Informed patients of appeals and denial processes.
Communicated with Utilization Review (UR) to ensure the accuracy of clinical information.
Maintained accurate knowledge of admission processing and regulations.
Maintained knowledge of medical insurance terminology.
Experience
5-7 Years
Level
Executive
Education
BS In Coordination
Reimbursement Coordinator Resume
Headline : Skilled Reimbursement Coordinator, possesses extensive knowledge of insurance billing procedures for medical supply reimbursement for patient care. Pays careful attention to detail and has excellent interpersonal skills. Extensive background in conflict resolution and customer care.
Skills : MS Office, Leadership Skills, Project Management Skills.
Description :
Responsible for the medical billing of the entire facility.
Prepared and submitted clean claims to various insurance companies either electronically or by paper.
Processed payments from insurance companies and prepared weekly deposits.
Identified and resolved insurance issues and patient billing complaints.
Prepared, reviewed, and sent patient statements.
Assisted in the development of internal processes and best practices for the reimbursement operations department.
Worked with billing to ensure accurate claims processing on authorizations.
Experience
5-7 Years
Level
Executive
Education
Bachelor Of Arts In Biology
Reimbursement Coordinator Resume
Summary : To obtain a challenging Reimbursement Coordinator position within an organization that will allow me to utilize my clinical, clerical, customer care, and/or administrative skills that I have acquired, while also providing a platform for growth and advancement.
Skills : Microsoft Office, Teamwork, Coordinating skills.
Description :
Worked closely with supervisors, practice managers, physicians, and all members of the health system to resolve discrepancies related to patient registration, including missing demographics information.
Followed work prioritization standards.
Assisted in the revision and maintenance of the chargemaster to comply with regulatory agencies' laws and regulations and payer requirements.
Processed & submitted claims thru Zirmed in a timely manner.
Coordinated audits of submitted cost reports by Medicare and Medicaid.
Filed secondary insurance claims.
Mailed patient statements for non-covered services.
Experience
7-10 Years
Level
Management
Education
High School Diploma
Reimbursement Coordinator Resume
Headline : To obtain a Reimbursement Coordinator position that provides a rewarding professional challenge where I can utilize my skills and help make an impact on company goals.
Skills : Management Skills, Multitasking, Communication Skills.
Description :
Facilitated access to appropriate support services, including reimbursement counseling, medical affairs, rebate and co-pay assistance foundations, etc.
Reviewed and processed CMS 1500 claim forms, UB claim forms, explanation of benefits, pharmaceutical invoices, and itemized statements from medical.
Identified with ICD 10, NCD, Dx codes, government, and private policies. Answered program inquiries regarding foundations requirements, scheduling.
Established a relationship with existing Medicare patients via telephone. Verified information on databases. Retrieved data from insurance coding portals.
Reconciled incomplete files. Collected additional information from the student population.
Investigated hundreds of health insurance claims, reviewed medical histories/records from nurses and doctors to determine patient necessities.
Generated financial reports from Peoplesoft and patient data reports from point click care.
Experience
5-7 Years
Level
Executive
Education
High School Diploma
Reimbursement Coordinator Resume
Summary : Reimbursement Coordinator with 2+ years of experience in working to ensure timely and accurate disposition on accounts receivables and coordinate reimbursement assessments.
Skills : Customer Service, Microsoft Office, Excellent Organizational Skills, Time Management.
Description :
Answered telephones and give information to callers, took messages, or transferred calls to appropriate individuals.
Greeted visitors or callers and handled their inquiries or directed them to the appropriate persons according to their needs.
Created, maintained, and entered information into databases.
Contacted Insurance Companies for authorizations for treatment.
Completed required paperwork for treatment requests for Medi-cal patients. Operated office equipment, such as fax machines, copiers, or phone systems, and arrange for repairs when equipment malfunctions.
Completed forms in accordance with company procedures.
Opened, read, routed, and distributed incoming mail or other materials and answer routine letters.
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