Kforce Reimbursement Counselor in Frisco, Texas

Kforce has a client that is seeking a Reimbursement Counselor for their office in Frisco, Texas (TX). Healthcare experience is preferred (especially with benefit verification experience) however they are also willing to look at those with call center customer service experience.Essential Duties:

  • Responsible for various reimbursement functions, including but not limited to accurate and timely claim submission, claim status, collection activity, appeals, payment posting, and / or refunds, until accounts receivable issues are properly resolved

  • Collects and reviews all patient insurance benefit information, to the degree authorized by the SOP of the program

  • Aids physician office staff and patients to complete and submit all necessary insurance forms and program applications

  • Completes and submits all necessary insurance forms and electronic claims to process the claims in a timely manner as required by all third-party payors

  • Researches and resolves any electronic claim denials. Researches and resolves any claim denials or underpayment of claims

  • Effectively utilizes various means for collections, including but not limited to phone, fax, mail, and online methods

  • Provides exceptional customer service to internal and external customers; resolves any customer requests in a timely and accurate manner; Escalates complaints accordingly

  • Maintains frequent phone contact with provider representatives, third-party customer service representatives, pharmacy staff, and case managers

  • Reports any reimbursement trends / delays to supervisor (e.g. billing denials, claim denials, pricing errors, payments, etc.)

  • Processes any necessary insurance / patient correspondence

  • Provides all necessary documentation required to expedite payments; This includes demographic, authorization / referrals, National Provider Identification (NPI) number, and referring physicians

  • Ability to build productive internal / external working relationships

  • Strong interpersonal skills

  • Strong negotiating skills

  • Strong mathematical skills

  • Strong organizational skills; attention to detail

  • General knowledge of accounting principles, pharmacy operations, and medical claims

  • General knowledge of HCPCS, CPT, ICD-9 and ICD-10 coding preferred

  • Global understanding of commercial and government payers preferred

  • Ability to proficiently use Microsoft Excel, Outlook and Word. Is developing professional expertise; applies company policies and procedures to resolve a variety of issues

Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.Compensation Type:Hours