Reimbursement Specialist

To coordinate and monitor reimbursement activities of a MFA department or group of MFA departments.

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Other duties may be assigned.

1. Coordinates billing activities with the MFA Business Office to include regular meetings to identify, address and resolve billing related issues.
2. Develops and implements departmental policies on managing MFA Business Office correspondence (i.e. account action forms, back-outs, information requests).
3. Maintains department physicians database on billing matters to include MFA provider numbers and third party provider numbers.
4. Develops and implements policies and procedures to enhance payment at time of service, ensure timely charge submission and ensure that the third party contractual agreements are met.
5. Analyzes end-of-month reports to provide information on the status of the department"&tm;s charges, allowances, bad debt and overall revenue; prepares appropriate billing reports and various summaries of billing activity.
6. Investigates and suggests new revenue sources.
7. Facilitates administrative control of the billing process through the coordination of related activities with appropriate departments.
8. Acts as a liaison with third party carrier professionals regarding reimbursement issues.
9. Assists physicians, staff and the MFA Business Office in the development of mechanisms to challenge claims as necessary.
10. Reviews coding structures to ensure conformity with CPT requirements.

Required Skills:
The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION
Bachelors' degree in accounting, business administration or related field, or an equivalent combination of training and experience, is necessary.

EXPERIENCE
Two years of responsible health care accounting/financial analysis experience is necessary.





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