Healthcare Reimbursement Specialist

Ball State University

Muncie, IN

ID: 7087083 (Ref.No. BSU27625)
Posted: October 13, 2021
Application Deadline: Open Until Filled

Job Description

The Healthcare Reimbursement Specialist will manage the private and third-party payment processes for the clinical operations within the College of Health (CoH).  The individual will be responsible for billing and claims management, payment processing, provider credentialing, prior authorizations, financial reporting, policy creation and administration, and other duties as assigned.  The Healthcare Reimbursement Specialist will utilize knowledge of insurance regulations, health insurance contracts, healthcare coding, and will provide a variety of support to the College’s clinical activities.

The College of Health invites applications for a Healthcare Reimbursement Specialist. The position will manage the private and third-party payment processes for the clinical operations within the College of Health (CoH).  The individual will be responsible for billing and claims management, payment processing, credentialing, prior authorizations, financial reporting, and other duties as assigned.  The Healthcare Billing Specialist will utilize knowledge of insurance regulations, health insurance contracts, healthcare coding, and will provide a variety of support to the College’s clinical activities.

Thank you for your interest in a career at Ball State University. We are committed to excellence through a talented and diverse faculty and staff. Inclusiveness and freedom of expression are a part of our enduring values and inform all of our efforts. We engage students in educational, research, and creative endeavors that empower our graduates to have fulfilling careers and meaningful lives enriched by lifelong learning and service, while we enhance the economic, environmental, and social vitality of our community, our state, and our world. We are excited that you want to join us in these endeavors!

The university offers excellent benefits, including health care and retirement plans, tuition assistance for employees and dependents, and generous time off with pay.

Job Function:

The Healthcare Reimbursement Specialist will manage the private and third-party payment processes for the clinical operations within the College of Health (CoH).  The individual will be responsible for billing and claims management, payment processing, provider credentialing, prior authorizations, financial reporting, policy creation and administration, and other duties as assigned.  The Healthcare Reimbursement Specialist will utilize knowledge of insurance regulations, health insurance contracts, healthcare coding, and will provide a variety of support to the College’s clinical activities.

Minimum Education:

Associate degree or equivalent from an accredited university.

Preferred Education:

Bachelor’s degree or equivalent from an accredited university with healthcare billing certificate and/or degree. 

Minimum Experience:

Three years or more performing healthcare coding and billing. 

Preferred Experience:

Five years or more performing healthcare coding, billing, and managing accounts receivable, in an outpatient rehabilitation setting.

Duties and Responsibilities:

  • Prepare and submit clean claims to third-party payers primarily through electronic data exchange.  Investigate claims issues and make recommendations to leadership for process improvement.  Monitor submitted claims, follow-up on unpaid claims, and initiate dialogue with insurance companies as needed 
  • Coordinate provider enrollments for commercial, state, and federal insurance programs.  Maintain up-to-date files for each licensed provider including information such as provider licensure status, certification renewals, and any external records through CAQH, PECOS, and NPPES.

  • Coordinate the process of client or patient eligibility through various third-party sources. Understand the terms and fee schedule of all third-party payer contracts.

  • Work with clients and third-party payers to identify, follow-up, and resolve any issues related to billing and payment.  Field and resolve billing and payment inquiries from clients, staff, or insurance companies. 

  • Manage monthly statement process including reviewing statements prior to their release.
  • Manage financial reporting.  Assist director with financial aspects and assemble data tables in the electronic health records and/or patient management systems.  Provide data to support quality control and quality assurance initiatives.

  • Collect, process, and manage payment for service-related fees or devices.  Coordinate and administer policy and procedure for sliding fee scale.  Coordinate payments for services with patients or third-party payers including but not limited to:  posting and managing account payments, pre-authorizing healthcare services or devices with insurers, and sending claims for services rendered, or devices dispensed, to insurers.

  • Maintain up-to-date knowledge on medical terminology and procedures related to healthcare coding including claims submission, prior authorizations, credentialing, diagnostic and procedural terminology (ICD-10, CPT, HCPC), and EOBs.  Ensure compliance with billing policies and guidelines for federal, state, and commercial third-party payers.


  • Serve as a coding subject matter expert in clinical department meetings.


  • Maintain patient confidentiality and adhere to CoH Clinic’s policies and procedures for securing protected health information.  Adhere to, and strictly follow, CoH Clinic’s policies on security related to clinical spaces and patient care and safety.

  • Create and maintain policy and procedures for all areas of job responsibilities.
  • Maintain regular and predictable attendance.
  • Perform other related duties as assigned.



At Ball State University, we recognize inclusive excellence as an integral endeavor to fulfill our University’s mission and our strategic plan. We recruit, support, and retain a diverse population of students, faculty, and staff. We encourage and reward diversity of thought. We promote a work environment that encourages and rewards innovation and creativity. We pledge to keep Inclusive Excellence at the highest level of institutional importance and as a foundation in all that we strive to do. Our over-arching goal for Inclusive Excellence is to adopt a university-wide Inclusive Excellence approach to academic, administrative support, and service functions of the university. We believe Inclusive Excellence must be infused in every step we take.



 

Apply Now

Please mention to the employer that you saw this ad on UniversityJobs.com