Reimbursement Specialists are responsible for processing insurance claims quickly and efficiently, as well as investigating claims issues and keeping patient files updated along the way. It’s an essential job because Reimbursement Specialists are there to ensure that patients receive accurate reimbursements for their claims. This position requires strong attention to detail and familiarity with clerical and office processes, as well as medical and insurance terminology.
Reimbursement Specialists can be found working in physician’s offices or at other health care and wellness facilities.
Typical Duties and Responsibilities
- Process claims quickly and accurately to ensure there are no errors
- Update patient medical files
- Investigate claims issues and make recommendations for process improvement
- Understand insurance carrier guidelines and stay abreast of any changes that occur to communicate them to management and staff
- Adhere to confidentiality, state, federal, and HIPPA laws and guidelines with regards to patient’s records
Education and Background
This position requires a high school diploma or GED.
Skills and Proficiencies
- Understand medical terminology, accounts receivable, insurance collections, and billing
- Expertise in written and verbal communication
- Ability to think independently
- Excellent interpersonal skills
- Ability to recognize and deal with priorities
According to Payscale the median annual salary of a Reimbursement Specialist with
1 Year of Experience:
- Orlando, Florida: $35,000
- Tampa, Florida: $34,000
- Jacksonville, Florida: $34,000
- Miami, Florida: $35,000
- Atlanta, Georgia: $35,000
- Chicago, Illinois: $38,000
- Houston, Texas: $35,000
- Los Angeles, California: $40,000
- New York City, New York: $35,000
- Seattle, Washington: $41,000
- Overall: $37,000
5 Years of Experience:
- Orlando, Florida: $38,000
- Tampa, Florida: $36,000
- Jacksonville, Florida: $38,000
- Miami, Florida: $40,000
- Atlanta, Georgia: $41,000
- Chicago, Illinois: $41,000
- Houston, Texas: $40,000
- Los Angeles, California: $49,000
- New York City, New York: $45,000
- Seattle, Washington: $49,000
- Overall: $42,000
Similar Job Titles
The career path for a Reimbursement Specialist starts by first obtaining a high school diploma or GED. While not always necessary to start, employers often prefer candidates that have earned certification through a professional organization like the American Medical Billing Association.
The health care industry is generally increasing in size year after year. More people are accessing health care services and making insurance claims for those services. All this activity creates a growing need for Reimbursement Specialists and people working in the health care billing field.
One reason for this growth is the aging population in the United States. Older people typically need more health care than young people. As the oversized baby-boom generation ages, the demand for health care services generally increases across the board.
The job outlook for medical records and health information specialists (which typically includes Reimbursement Specialists), is bright, with 11 percent job growth projected through 2028, according to the U.S. Bureau of Labor Statistics. This is considered faster than average growth.
The typical work hours for a Reimbursement Specialist can be from 9 a.m. to 5 p.m. Monday through Friday in an office setting.
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