Certified Medical Reimbursement Specialist
Location: Bennington, Vermont, United States
Bennington College invites applications for a Certified Medical Reimbursement Specialist to join a dynamic and fast-paced Health Services team.
The Certified Medical Reimbursement Specialist is responsible for handling and resolution of all coding-related billing matters to ensure prompt and accurate reimbursement of student claims. The work involves collecting, verifying and updating insurance information including co-pays, medical records review and recommending pre-billing coding. The Specialist is responsible for communicating with the billing insurance company to ensure accurate and efficient processing of bills; reconciles discrepancies to ensure timely/accurate resubmission of bills.
The position works on average 15 hours/week during term time (32 weeks/year).
Key Responsibilities
- Coordinate all insurance services in the Counseling and Psychological Services Office (CAPS) to ensure timely and accurate student insurance billing and maximize reimbursements for the College.
- Handle and resolve coding-related billing matters to ensure prompt and accurate reimbursement.
- Collect, verify and update insurance information including co-pays, medical records review and recommending pre-billing coding. Ensure that super bill templates are generated by clinicians in a timely manner.
- Code superbills for maximum reimbursement; collaborate with clinicians to guide on pre billing coding.
- Assess clinical documentation supporting services and work collaboratively with CAPS staff regarding missing/unclear clinical documentation.
- Review and resolve all assigned tasks/encounters associated with coding discrepancies as it relates to pre-billing system edits and/or claims with outstanding balances.
- Transmit super bills to designated billing companies.
- Collect and log co-pays received.
- Track the reimbursements sent to the Student Health Center.
- Reconcile payments received from patients.
- Reconcile the EFTs.
- Communicate with the billing insurance company to ensure accurate and efficient processing of bills; reconcile discrepancies to ensure timely/accurate resubmission of bills.
- Manage appeals or pre-authorizations with insurance companies when appropriate.
- Serve as liaison between clinicians, billing consultants, and insurance carriers to discuss coding matters.
- Serve as a point of contact for students who have billing insurance inquiries. Receive, evaluate and resolve inquiries in a timely and respectful manner.
- Maintain tracking reports when issues and trends have been identified. Compile data and run reports; provide regular reporting to CAPS directors for matters including analysis of services offered and clinician services.
- Maintain patient confidentiality; comply with HIPAA and related compliance guidelines using established procedures set by CAPS and other entities.
- As needed, support special projects and/or other administrative functions within the Offices of Counseling and Psychological Services and Health Services to ensure effective and efficient coordination of duties and operation of these departmental services.
Bennington serves a diverse student population inclusive of members of ethnically/racially minoritized, international, LGBTQIA+, and disability communities as well as diverse gender identities, socioeconomic backgrounds, religions, and political beliefs. Our staff and faculty also reflect diverse and intersecting backgrounds and identities. All employees are expected to be respectful and responsive to these differences in the service of building community that promotes student and employee success and community cohesiveness. Each individual (faculty, staff and students) will be accountable for upholding these values. The College’s approach to pluralism and inclusivity—both as fields of inquiry and practice—is to prioritize flexible thought, and to invite the examination of access, value, power, and privilege through its institutional policies and areas of study. We encourage applicants from diverse realms of interest, backgrounds, experience, and accomplishment to apply.
Qualifications
- Minimum education of high school diploma or GED equivalent; undergraduate degree preferred.
- Certified Professional Coder (CPC)
- Related certified medical billing experience required; minimum 5 years’ experience preferred.
- Knowledge of CPT and ICD-IO coding.
- Strong written and verbal communication skills.
- Proficient in use of Google Suite and experience with electronic medical records (Practice Fusion preferred), and Excel as well as experience managing and reporting data using spreadsheets/reports.
- Must be able to work with limited direction, handle multiple tasks and produce accurate and timely reports. Must have the ability to pay attention to detail.
- Must have excellent communication skills and must exercise good judgment at all times.
- Demonstrated ability to accept sensitive/confidential information/situations and to facilitate initial handling/processing.
- Must be able to handle a high volume of work.
- Requires keen attention to detail; ensuring complete accuracy is a critical component of this work.
This position requires successful completion and acceptable results of a background check.
The College
Bennington College is a laboratory for innovation in higher education. At Bennington, learning and making—on campus and in the field—are inseparable, and its graduates are noted for their outsized impact on the world’s stage. This campus celebrates the ongoing making of work—shared on walls, in shows and performances, in lectures and readings, and in conversations—and believes that equity, diversity, and inclusivity are vital to a collaborative community. This position captures, contributes to, and reflects the ethos of this creative community.
Nestled at the foot of the Green Mountains in Vermont, the campus consists of approximately 370 acres. The College was named one of ten with the best architecture by Architectural Digest. From campus, it is a short drive to the cultural offerings of the northern Berkshires in Massachusetts, Albany, New York, and many of Vermont’s top recreational centers. New York City, Boston, and Burlington, Vermont are all within three and a half hours by car.
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