Patient Financial Services Reimbursement Specialist II - Full Time

Full-Time: Monday-Friday 8:00am-4:30pm. Hybrid-Remote. 

Northwell is the largest not-for-profit health system in the Northeast, serving residents of New York and Connecticut with 28 hospitals, more than 1,000 outpatient facilities, 22,000 nurses and over 20,000 physicians. Northwell cares for more than three million people annually in the New York metro area, including Long Island, the Hudson Valley, Connecticut and beyond, thanks to philanthropic support from our communities. Northwell is New York State’s largest private employer with over 104,000 employees — including members of Northwell Health Physician Partners — who are working to change health care for the better.

Summary:

The Patient Financial Services Reimbursement Specialist II plays a vital role in managing the complete lifecycle of patient financial accounts from initial creation through final resolution. This position ensures seamless claims processing, accurate payment application, and effective denial management while maintaining compliance with billing regulations. With a strong focus on optimizing reimbursement, the specialist proactively monitors accounts, facilitates timely follow-up, and collaborates with internal and external stakeholders to resolve outstanding balances. Their expertise supports the organizations financial integrity and enhances the overall patient experience by ensuring a smooth and efficient reimbursement process.

Responsibilities:

1. Accurately processes claims, payments, rejections, refunds, credit balances and unapplied cash on a daily basis and performs timely follow-up. 2. Responsible for daily completion and correction of information for claims edit lists and rejections. 3. Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries. 4. Provides immediate access to explanation of benefits (EOB's), reports and other information as requested. 5. Offers guidance and training and provides performance input to Level I staff member's if requested. 6. Supports the Team Leader in monitoring the accuracy and completion of the cash application process. 7. Identifies departmental problems associated with procedures, system functionality, staff training and education, and reimbursement issues. Makes recommendations to management for improvement and resolution. 8. Performs trend analysis for management in order to determine registration & documentation deficiencies throughout the organization. 9. Adheres to all policies and procedures related to federal, state and department compliance for the position. 10. Maintains and Model the Organizations values. 11. Demonstrates regular, reliable and predictable attendance. 12. Performs other duties as required.

Education Skills Experience:

High School Graduate or Equivalent required. Data entry, MS Excel and customer service experience required. One year minimum experience in billing and collections required.
Medical Terminology, billing, cash applications and collections experience desired.

Working Conditions:

• Manual: significant manual skills/motor coord & finger dexterity
• Occupational: Little or no potential for occupational risk
• Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Company: Nuvance Health
Org Unit: 1826
Department: Patient Accounting Med Practic
Exempt: No
Salary Range: $21.49 - $41.73 Hourly