Description We are in search of a Medical Reimbursement Specialist to join our team. Stationed in Princeton, New Jersey, you will be instrumental in tackling a backlog of aged medical claims and refining our reimbursement process. This role offers a long-term contract employment opportunity in the medical industry, where you will be tasked with tasks such as claims processing, denial management, payer follow-ups, and appeals.

Responsibilities:

• Analyze and categorize outstanding claims based on payer, denial reason, and claim value.

• Investigate and take corrective action on unpaid, denied, or underpaid claims.

• Collaborate with internal teams to obtain missing documentation and expedite claim resubmission.

• Evaluate common denial reasons and address them accordingly, such as coding errors, medical necessity, and prior authorization.

• Submit corrected claims and formal appeals as required.

• Communicate with insurance payers to resolve aged claims and escalate unresolved claims as necessary.

• Maintain comprehensive records of all payer interactions.

• Identify the root causes of denials and implement best practices to prevent future issues.

• Suggest changes to workflow to enhance claim submission accuracy and speed.

• Conduct training for in-house billing teams on claim recovery strategies. Requirements

• Minimum of 3 years of experience in a similar role

• Proficient in benefit functions

• Demonstrated expertise in billing functions

• Experience in claim administration

• Familiarity with collection processes

• Ability to handle and resolve medical denials

• Comprehensive knowledge of Medicare

Robert Half is the world’s first and largest specialized talent solutions firm that connects highly qualified job seekers to opportunities at great companies. We offer contract, temporary and permanent placement solutions for finance and accounting, technology, marketing and creative, legal, and administrative and customer support roles.

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All applicants applying for U.S. job openings must be legally authorized to work in the United States. Benefits are available to contract/temporary professionals, including medical, vision, dental, and life and disability insurance. Hired contract/temporary professionals are also eligible to enroll in our company 401(k) plan. Visit roberthalf.gobenefits.net for more information.

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