I touched on each one of these responsibilities in my medical insurance billing coursework

Responsibilities of the Reimbursement Specialist include the following:

1. Observe legal and ethical guidelines for safeguarding the confidentiality of patient and proprietary information.

2. Understands billing requirements for Medicare, Medicaid, contracted and commercial payers

3. Follows up on denials in a timely manner and proactively communicates any denial issues related to billing requirements

4. Reviews EOB for proper reimbursement

5. Monitors contracts and single patient agreements to ensure appropriate reimbursement is received

6. Ensures timely filling requirements are met and claims are followed up on in a timely and appropriate manner to eliminate timely filing denials and non-payment of claims

7. Understands governmental and commercial compliance regulations related to healthcare billing and accounts receivable management and where to locate the regulations

8. Reviews and researches insurance correspondence and makes necessary corrections to ensure claims payment

9. Follows up on unresolved account balances

10. Understanding of both UB04 claim for and CMS 1500 claim form

11. Provides insurance carriers with requests as necessary and timely