Reimbursement Representative

Overview

USRC's greatest strength in being a leader in the dialysis industry is our ability to recognize and celebrate the differences in our diverse workforce. We strongly believe in recruiting top talent and creating a diverse and inclusive work climate and culture at all levels of our organization. SUMMARY The Reimbursement Representative performs reconciliation and review of all outstanding Medicare/Commercial patient balances in accordance with US Renal Care reimbursement policies and procedures.

Essential Duties and Responsibilities

include the following. Other duties and tasks may be assigned. Reviews EOB/EOMB's for proper reimbursement. Resolves electronic claim rejections and Explanation of Benefits denials in a timely manner. Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment. Follows up on unpaid/unresolved account balances, including claims rejected electronically, EOB denial and working A/R aging reports as directed.

Provides insurance carriers with requested information to facilitate payment. Regularly contacts Medicare, Medicaid and /or Commercial payors for resolution to claims not paid or claims not paid according to plan benefits. Performs claim appeals as required. Assists with credit balance resolution. Completes re-bill request as necessary to facilitate timely and proper claims payment.

Follows up on unresolved account balances including RTP's. Prepares adjustment and write-off requests as necessary. Performs other duties and responsibilities as required or assigned.