Reimbursement Specialist

Full Time | First Shift
Bronson Healthcare Group

Location: Bronson Healthcare Group
Requisition ID: JOB46411

CURRENT BRONSON EMPLOYEES: Please apply using the career worklet in Workday. This career site is for external applicants only.

Love Where You Work

Team Bronson is compassionate, resilient, and strong. We are driven by positivity, inspiring us to be our best and go above and beyond for our patients, for one another, and for our community.

If you’re ready for a rewarding career in healthcare revenue cycle operations, join Team Bronson and be part of the experience.

Position Summary

The Reimbursement Specialist is responsible for supporting the healthcare revenue cycle by ensuring accurate billing, payment processing, and reimbursement from third-party payers. This role works to resolve billing issues, reduce outstanding accounts receivable, and ensure compliance with payer requirements and government regulations.

Responsibilities include reviewing claims for accuracy, managing payer communications, analyzing reimbursement, and maintaining current knowledge of insurance contracts and regulatory guidelines.

Employees providing direct patient care must demonstrate competencies specific to the population served.

Education & Experience

Required

• High school diploma or GED

Preferred

• Associate’s degree in Business, Finance, or related field

• Experience in medical billing, accounts receivable, or healthcare collections

Additional Requirements

• Successful completion of Epic User Proficiency Assessments (EUPAs) for all Epic applications associated with the position within 90 days of hire

Key Responsibilities

Claims Processing & Reimbursement

• Ensure claims comply with payer specifications and state, federal, and HIPAA regulations

• Review and analyze billing information to ensure accurate claim submission

• Prepare documentation to maximize reimbursement from third-party payers

• Resolve billing issues early to improve reimbursement and reduce claim rejections

Accounts Receivable & Claim Resolution

• Investigate and resolve claim denials, rejections, and payer requests

• Analyze payer responses and internal documentation to resolve outstanding accounts

• Process adjustments, refunds, and contractual allowances as necessary

• Assist with resolving outstanding credits and unbilled accounts

Coding & Billing Review

• Review CPT-4, ICD-10, UB-04, and HCFA-1500 billing data for accuracy

• Ensure proper charge capture and billing practices

• Support accurate documentation to facilitate compliant reimbursement

Revenue Cycle Systems & Reporting

• Utilize multiple revenue cycle systems including:

  • Epic

  • SSI

  • OnBase

  • External payer portals and eligibility systems

• Verify insurance eligibility using automated systems

• Maintain accurate account documentation and billing records

Regulatory Compliance

• Maintain working knowledge of payer contracts and government reimbursement regulations

• Ensure billing practices align with compliance and regulatory requirements

• Assist with referrals for legal intervention when appropriate

Skills & Qualifications

• Strong understanding of healthcare billing and reimbursement processes

• Knowledge of medical terminology, ICD-10 and CPT coding, and payer billing requirements

• Ability to analyze and resolve complex billing and reimbursement issues

• Strong organizational and problem-solving skills

• Excellent communication and customer service abilities

• Proficiency with computers and general office systems

• Typing ability of 45 words per minute

Physical Requirements

• Position involves significant computer use (approximately 70–90% of the workday)

• Requires sustained attention to detail and concentration

• Occasional standing, walking, or lifting of light objects may be required

Shift: First Shift
Time Type: Full Time
Scheduled Weekly Hours: 40
Cost Center: 1204 Patient Accounting – Commercial/Managed Care (BHG)