Creating Life Better Here starts with you. At San Juan Regional Medical Center, we're more than a healthcare provider—we're a values-driven organization dedicated to delivering exceptional care. As a team member, you help fulfill our mission to make life better here for our community.

The Reimbursement Specialist is entrusted to set a positive tone for every customer. They also demonstrate the ability to be a self motivated, energetic person who can interact with third party payers in a courteous manner. The Reimbursement Specialist: coordinates the customers questions and serves as the communication for the CBO, in an attentive, courteous, and competent manner; serves as the liaison between patients and the insurance companies while demonstrating self-confidence, adaptability and personal initiative; maintains a positive attitude and remains calm under pressure.

Required Behaviors:

As you go about fulfilling this mission, your work habits and work relationships should embody SJRMC's values. These values are our culture, our identity as an organization: Sacred Trust, Personal Reverence, Thoughtful Anticipation, Team Accountability and Creative Vitality ask more of us than merely completing some list of tasks. Our values ask for a deeper level of commitment, and what is asked of us we freely give because we believe in our mission.

Required Qualifications:

High School education or GED
Knowledge of computer keyboarding
Good communication skills
Good telephone technique

Preferred Qualifications:

Knowledge of 3rd party payers (i.e., Medicaid, Medicare, Commercial)
Medical Terminology and coding experience

Duties and Responsibilities:

Responsible for filing insurance claims for all third party payers in a timely and accurate manner
Ensures goals and objectives established with CBO Manager are attained
Mail appropriate forms to payers and/or patients
Posting all payments received from insurance and patients, timely and efficiently
Coordinating billing and limited follow-up activity associated with the collection of patient accounts
Stays informed of changes in billing procedures that impact process and /or reimbursement effectiveness
Professional appearance
Commitment to successful operation of the clinic billing office
Maintain strict patient confidentiality
Documents relative information on patients accounts as per CBO protocol
Each employee is responsible for implementing SJRMC’s Service Standards into their daily work:

Safety, Courtesy, Effectiveness, and Stewardship

Other duties as assigned

Physical Demands and Environmental Work Conditions:

Lifting up to twenty-five (25) pounds is required
Job is sedentary in nature and involves long periods of sitting
Extensive computer keyboarding
Posting involve communicating with clients/patients face to face, as well as on the phone

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