A Reimbursement Coordinator ensures that the patients are charged accurately for the medical services provided to them. The most common work activities seen on the Reimbursement Coordinator Resume include the following – serving as a patient advocate for identifying reimbursement coverage options, identifying reimbursement options for the non-insured patients; recording and monitoring insurance authorizations to ensure payment compliance and treatment continuity; maintaining and analyzing data about cases that need reimbursement support; and working with treatment providers and insurance companies for obtaining payment authorizations.
To qualify for this role, generally, a registered nurse along with a state certification is needed. Extensive knowledge with Minimum data set is also required. Those who want to succeed in this role should also have the right personality qualities such as a methodical and precise work approach, record maintaining skills; proficiency in writing and speaking, and strong interaction skills.
Objective : Dedicated Reimbursement Coordinator with 2 years of experience in managing insurance claims and resolving denials. Skilled in ensuring accurate billing processes and maintaining compliance with payer requirements. Proven ability to communicate effectively with patients and healthcare providers to streamline reimbursement processes and enhance patient care.
Skills : Patient Account Management, Data Analysis Tools, Data Entry, Medical Coding
Description :
Managed all aspects of patient accounts, including eligibility verification and financial expectations, utilizing online systems and telephonic methods.
Maintained accurate documentation of all registration and financial data within the computer system.
Identified and selected appropriate insurance plan codes to ensure correct billing.
Responded to inquiries regarding billing, insurance requirements, and services offered across various programs.
Directed calls to the relevant departments and personnel to enhance service efficiency.
Developed effective strategies to handle challenging customer interactions professionally.
Collected supporting documentation from facilities to substantiate Medicare coinsurance claims.
Experience
0-2 Years
Level
Entry Level
Education
AAS in HIT
Healthcare Reimbursement Coordinator Resume
Objective : Accomplished Healthcare Reimbursement Coordinator with over 5 years of experience in optimizing claims processes and enhancing reimbursement accuracy. Expertise in navigating complex payer systems, managing denials, and ensuring compliance with regulatory standards. Committed to continuous improvement and fostering effective communication between patients, providers, and payers to streamline reimbursement workflows.
Processed and submitted claims to Medicare, Medicaid, and private insurers, ensuring adherence to payer guidelines.
Monitored outstanding claims and facilitated follow-ups to expedite payments.
Maintained comprehensive logs for cost reports and reimbursement tracking.
Compiled and submitted Medicare Credit Balance reports to ensure accurate financial reporting.
Adhered to HIPAA regulations while managing sensitive patient information.
Manage and process reimbursement claims for healthcare services efficiently.
Evaluated payer authorization requirements to optimize claim processing.
Experience
2-5 Years
Level
Junior
Education
B.S. Health Admin
Reimbursement Coordinator Resume
Headline : Proficient Reimbursement Coordinator with 7 years of extensive experience in managing complex insurance claims and optimizing reimbursement processes. Demonstrated success in ensuring compliance with payer regulations and enhancing operational efficiency. Adept at collaborating with healthcare professionals and patients to facilitate accurate billing and improve overall reimbursement workflows.
Pre-registered and verified insurance eligibility and benefits prior to patient appointments.
Ensured accurate coding compliance with Federal, State, and various Insurance carriers.
Managed pre-certification and authorization processes for patient admissions.
Reviewed evaluations, charts, and productivity reports to ensure billing accuracy.
Conducted training sessions for staff on payer documentation and coding standards.
Maintained communication with referring providers to secure necessary consultations and signatures.
Identified payment trends and provided insights to the financial department regarding denials.
Experience
5-7 Years
Level
Senior
Education
B.S. in HA
Insurance Reimbursement Coordinator Resume
Summary : With a decade of experience as an Insurance Reimbursement Coordinator, I specialize in optimizing claims processing and improving reimbursement accuracy. My expertise encompasses navigating complex payer systems, managing denials, and ensuring compliance with regulations. I am dedicated to enhancing operational efficiency and fostering clear communication among patients, providers, and payers.
Communicate with patients regarding their reimbursement status.
Resolve discrepancies in reimbursement claims promptly.
Maintain detailed records of all reimbursement transactions.
Coordinated with field staff and clinicians to ensure proper authorization for patient visits.
Documented all account activities in the electronic system for accurate record-keeping.
Responded to patient inquiries about insurance coverage and authorization statuses.
Reviewed patient accounts for completeness, identifying issues and implementing corrective actions for resolution.
Experience
7-10 Years
Level
Management
Education
AAS HIT
Reimbursement Coordinator Resume
Summary : As a seasoned Reimbursement Coordinator with 10 years of experience, I excel in optimizing claims management and enhancing reimbursement processes. My expertise in regulatory compliance and payer relations drives operational efficiency. I am committed to fostering clear communication and collaboration among patients, providers, and payers to ensure timely and accurate reimbursement outcomes.
Directed and facilitated educational initiatives with insurers and healthcare professionals to promote Positron Emission Tomography (PET) services.
Coordinated patient scheduling and managed precertification processes for PET examinations.
Reviewed and validated patient records, ensuring accurate diagnosis (ICD) and procedure (CPT) coding for insurance submissions.
Provided comprehensive financial and compliance support within the Medical Imaging Department.
Executed various administrative functions to enhance departmental efficiency.
Analyzed and reported on PET exam benefits, increasing national awareness and investment returns.
Enhanced revenue through strategic marketing of PET services and effective management of accounts receivable.
Experience
10+ Years
Level
Executive
Education
B.S. Health Admin.
Clinical Reimbursement Specialist Resume
Objective : Results-oriented Clinical Reimbursement Specialist with 2 years of experience in optimizing claims management and minimizing denials. Expertise in ensuring compliance with payer regulations and enhancing billing accuracy. Committed to fostering collaboration among healthcare teams and patients to streamline reimbursement processes and improve overall patient outcomes.
Skills : Claims Administration, Problem Solving, Claims Processing, Attention To Detail
Description :
Ensured compliance with payer requirements while processing insurance claims.
Coordinated with healthcare teams to resolve issues related to claims and denials.
Educated patients on the appeals process and addressed their inquiries regarding insurance.
Maintained thorough knowledge of admission processing and medical insurance terminology.
Collaborated with Utilization Review to verify clinical information accuracy.
Consistently adhered to contractual filing and appeals processes.
Respond to inquiries from insurance companies regarding claims.
Experience
0-2 Years
Level
Entry Level
Education
B.S. Health Admin
Reimbursement Coordinator Resume
Objective : Proactive Reimbursement Coordinator with 2 years of expertise in managing insurance claims and ensuring compliance with billing standards. Adept at resolving denials and enhancing billing accuracy through effective communication with patients and providers. Committed to streamlining reimbursement processes to improve overall patient experience and operational efficiency.
Skills : Billing Software Proficiency, Team Collaboration, Analytical Skills, Process Improvement, Insurance Appeals, Revenue Cycle Management
Description :
Managed comprehensive medical billing operations for the facility.
Submitted accurate claims to various insurance providers, both electronically and manually.
Processed insurance payments, ensuring timely deposits for the organization.
Resolved patient billing inquiries and addressed insurance-related issues effectively.
Generated and reviewed patient statements, ensuring clarity and accuracy.
Contributed to the creation of streamlined processes for the reimbursement department.
Collaborated with billing teams to enhance claims processing accuracy and efficiency.
Experience
0-2 Years
Level
Fresher
Education
AAS HIT
Clinical Reimbursement Coordinator Resume
Headline : Experienced Clinical Reimbursement Coordinator with 7 years of expertise in managing complex insurance claims and ensuring compliance with payer regulations. Recognized for enhancing reimbursement accuracy and fostering effective communication among healthcare teams. Committed to streamlining processes to optimize patient outcomes and operational efficiency.
Collaborated with healthcare providers to resolve patient registration discrepancies, ensuring accuracy in demographic data.
Prioritized work tasks to enhance operational efficiency in claims processing.
Maintained and revised the chargemaster to align with regulatory standards and payer requirements.
Processed and submitted claims through Zirmed, ensuring timely reimbursement.
Coordinated Medicare and Medicaid audits, ensuring compliance with regulatory standards.
Filed secondary insurance claims to maximize reimbursement opportunities.
Generated and mailed patient statements for non-covered services, improving transparency.
Experience
5-7 Years
Level
Senior
Education
BSHA
Reimbursement Coordinator Resume
Objective : Detail-oriented Reimbursement Coordinator with over 5 years of experience in managing claims processing and ensuring compliance with healthcare regulations. Proven track record in optimizing reimbursement processes, reducing claim denials, and enhancing revenue cycle efficiency. Strong analytical skills and proficiency in billing software, dedicated to improving patient satisfaction and financial outcomes.
Facilitated access to reimbursement counseling and support services, enhancing patient experience.
Reviewed and processed CMS 1500 and UB claim forms, ensuring accuracy and compliance.
Utilized ICD-10 and NCD codes to resolve claims issues and answered inquiries regarding program requirements.
Established strong relationships with Medicare patients, verifying and updating information in databases.
Reconciled incomplete files and collected additional data to expedite claims processing.
Investigated health insurance claims by analyzing medical histories and collaborating with healthcare providers.
Generated detailed financial reports from PeopleSoft to track reimbursement metrics.
Experience
2-5 Years
Level
Consultant
Education
B.S. Health Admin
Reimbursement Coordinator Resume
Objective : Results-driven Reimbursement Coordinator with expertise in medical billing and coding, adept at navigating complex insurance policies and reimbursement processes. Skilled in analyzing claims data to identify trends and implement corrective actions. Excellent communication and negotiation skills, committed to maximizing reimbursements while maintaining compliance with industry standards.
Maintained detailed records of claims submissions and payments, optimizing the revenue cycle.
Collaborated with healthcare providers to obtain necessary authorizations for treatments.
Conducted regular audits of claims to identify errors and implement corrective measures.
Trained staff on billing processes and software usage to improve operational efficiency.
Developed and maintained relationships with insurance representatives to facilitate smooth claims processing.
Experience
2-5 Years
Level
Junior
Education
B.S. in HA
Clinical Reimbursement Coordinator Resume
Objective : Dynamic Clinical Reimbursement Coordinator with 5 years of specialized experience in optimizing claims processes and enhancing reimbursement accuracy. Proficient in navigating payer regulations, managing denials, and ensuring compliance. Passionate about fostering collaboration among healthcare professionals and patients to streamline reimbursement workflows and improve overall operational efficiency.
Served as the primary coordinator for Medicare assessments, ensuring compliance and accuracy.
Conducted thorough progress reviews for residents to optimize reimbursement outcomes.
Facilitated discharge planning and managed durable medical equipment (DME) needs.
Ensured proper clinical reimbursement while balancing patient needs with company objectives.
Oversaw departmental operations to capture optimal clinical reimbursement in line with federal guidelines.
Assessed and addressed medical needs of patients to enhance service delivery.
Managed Medicare and Medicaid case-mix documents, maximizing reimbursement for services rendered.
Experience
2-5 Years
Level
Junior
Education
BSHA
Clinical Reimbursement Coordinator Resume
Summary : Results-driven Reimbursement Coordinator with expertise in medical billing and coding, specializing in maximizing reimbursements and minimizing claim rejections. Adept at analyzing complex reimbursement issues and implementing effective solutions. Strong organizational skills and attention to detail, with a commitment to maintaining accurate records and ensuring timely submissions to insurance companies.
Skills : Customer Service, Communication Skills, Time Management, Software Proficiency, Hipaa Compliance, Research Skills
Description :
Led initiatives to optimize the Department of Public Health's strategic plan for health equity, enhancing reimbursement outcomes.
Collaborated with stakeholders to address health inequities, fostering partnerships that improved funding opportunities.
Applied data-driven methodologies to manage projects related to health equity and reimbursement strategies.
Evaluated departmental progress towards reimbursement goals and adjusted strategies accordingly.
Identified funding opportunities that aligned with reimbursement strategies, enhancing financial support for programs.
Supported staff in grant applications to align with strategic reimbursement initiatives.
Monitored emerging trends to improve health outcomes and reimbursement processes.
Experience
7-10 Years
Level
Management
Education
B.S. Health Admin.
Clinical Reimbursement Coordinator Resume
Summary : Bringing a decade of expertise in clinical reimbursement, I excel in managing complex insurance claims and optimizing reimbursement strategies. My proficiency in regulatory compliance and payer relations enhances operational efficiency and accuracy in billing processes. I am dedicated to fostering collaboration among healthcare teams and patients to ensure timely and effective reimbursement outcomes.
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