Claims Reimbursement Specialist

Medical Associates of NWA•Fayetteville, AR

21h•Hybrid

About The Position

The Claims Reimbursement Representative is responsible for researching and resolving insurance billing issues at the time of claims submission, upon receipt of denial or non contracted payment, and refund requests assigned to specific insurance(s) and providers/specialties. Interact daily including but not limited to insurance companies, clinics, other CBO departments and MANA administration. This position is primarily remote. However, the role requires occasional on-site presence. About MANA Administration The MANA Administrative team provides support services for 27 physician-owned medical practices in Northwest Arkansas. We are an independent, physician owned group established in 1999 to responsibly manage the costs associated with health care, improve our practice efficiencies, and enhance overall care for our patients. Our administrative team includes Human Resources, Physician Services, Information Systems, Population Health, Accounting, Reimbursement, Compliance, Communications, Billing Services, and more! We all work together to help our physicians and clinics provide compassionate, comprehensive, quality health care. We support each other, often working on projects together, and maintain a healthy work-life balance. About MANA Medical Associates of Northwest Arkansas (MANA) is an independent, physician-owned healthcare organization offering family medicine, pediatrics, women’s health, and a wide range of specialty and advanced services. As a physician-owned practice, MANA prioritizes compassionate, high-quality patient care while maintaining a personal, patient-centered clinic environment. Our team works together to manage healthcare efficiently, support excellent patient outcomes, and provide comprehensive care. Our mission is to improve the quality of life by providing compassionate, comprehensive, quality healthcare.

Requirements

Equivalent to four years high school or GED
12 to 18 months related experience and/or training, or equivalent combination of education and experience
Experience with Medicare and Medicare Advantage billing and coding guidelines, Availity, NCD and NCCI edits

Responsibilities

Ensure insurance is set up correctly in the patient's account in ECW
Respond appropriately to insurance companies' requests for information in a prompt and professional manner.
Initiate adjustments to accounts promptly upon receipt of explanation of benefits.
Demonstrate a thorough knowledge of CPT and ICD coding guidelines, as well as individual insurance carrier policies. Keep up to date on all changes in these areas.
Follow-up on all claim denials and exercise all available options to obtain claim reimbursement. Submit corrected claims promptly.

Benefits

Medical Insurance
Vision Insurance
Dental Insurance
HSA or FSA options with medical insurance
Voluntary Aflac Accident and Critical Illness
Employer paid life, long-term & short-term disability benefits
401(K) match and profit sharing
Up to 21.5 paid days off (PDO, EID and Perfect Attendance benefits) & 6 days paid holidays; during your first year of employment
Corporate Discounts: MANA has partnerships with various local and nationwide retailers to provide discounts to you; Dell, ATT, Verizon, UARK Federal Credit Union, and many more!
One-On-One Training and Development: At time of hire with MANA, you will go through detailed training to ensure you are equipped with what you need for success in our clinics