JOB SUMMARY:

Under the direction of PFS Leadership the Reimbursement Specialist II is responsible for billing and collections of outstanding account balances for commercial government and managed care payors as assigned. The Reimbursement Specialist II is required to identify and report payor issues to their leadership. It is a requirement for the Reimbursement Specialist II to read interpret and apply sophisticated payor contract language to expected reimbursement calculations and pursue all payments due to the organization. The Reimbursement Specialist II must perform account collection activities using internet resources and professional telephone communication etiquette. The Reimbursement Specialist II is required to compose professional written correspondence with all internal and external entities. This position expects the Reimbursement Specialist II to demonstrate organization and time leadership skills to manage account collections. The Reimbursement Specialist II identifies payer trends in regards to denials/underpayments and makes appropriate recommendations. Works with payers to resolve denial and underpayment trends. Has a detailed knowledge of the revenue cycle and able to identify process problems impacting Accounts Receivable.

REQUIRED SKILLS:

• Strong analytical skills
• Expert communicator
• Creative problem-solver
• Exceptional time-management skills

PREFERRED QUALIFIATIONS:

• Associate Degree
• Certification as a HFMA Credentialed Revenue Cycle Representative

Please refer the Job description for details