Payment Review Specialist

Payment Review Specialist Abbott is a global healthcare leader, creating breakthrough science to improve people’s health. We’re always looking towards the future, anticipating changes in medical science and technology. In Abbott’s Heart Failure (HF) business, we’re developing solutions to diagnose, monitor and manage heart failure, allowing people to restore their health and get on with their lives. Working at Abbott At Abbott, you can do work that matters, grow, and learn, care for yourself and family, be your true self and live a full life. You will have access to: • Career development with an international company where you can grow the career you dream of. • A company recognized as a great place to work in dozens of countries around the world and named one of the most admired companies in the world by Fortune. • A company that is recognized as one of the best big companies to work for as well as a best place to work for diversity, working mothers, female executives, and scientists.

As the Payment Review Specialist , you will process all Medicare, commercial and patient refunds, while resolving invoice under-payments and over-payments. What You’ll Do • Evaluate patient accounts for payment status (i.e., who, what, amount paid) against what was returned and what is being refunded. • Resolve invoice under payments and over payments in a timely manner. • Communicate with Medicare directly to assess claims. • Fill out refund forms for accounting for check request. • Credit accounts when necessary, make copies of documents and mail original back-ups along with check to Medicare. • File all documents (back-up copies) in appropriate areas. • Comply with all State, Federal, professional regulations as well as department rules, policies and procedural information. • Respond promptly when returning telephone calls and replying to correspondence and faxes. • Verify that payments received are correct according to the fee schedule. • Apply payments correctly to assigned patient accounts, including Medicare auto posting checks, patient cash, and adjustments as needed. • Keep Supervisor and Manager informed of payment and denial trends. • Read and interpret an Explanation of Benefits. • Meet all month-end requirements. • Maintain proficiency in the knowledge of equipment and services offered by the company. • Work as part of the company team by communicating effectively with all departments. • Observe legal and ethical guidelines for safeguarding patient and company confidentiality (HIPAA). • Provide exceptional customer service to both internal and external customers. • Interact in a professional manner with all teammates and customers. • Promote the company culture by adhering to policy, procedure, and mission statement. • Complete assigned work in a timely and efficient manner. • Adapt to frequent changes in the work environment. • Meet individual, departmental, and company goals. • Perform other duties as assigned. Requirements • Medical insurance billing knowledge and coding language skills. • Thorough understanding of claims reimbursement processes, including denials and cash posting. • Proficient Medicare and solid general payers' knowledge. • Strong research, review, and analysis skills. • Understanding of physician diagnosis choices and application of appropriate billing codes. • Knowledge of medical terminology, anatomy, and disease treatments. • Strong reading and data entry typing skills. • Excellent attention to detail and accuracy in data entry and billing activities. • Strong written and oral communication skills. • Ability to interact effectively with medical personnel, insurance companies, and patients via phone and email. • Active listening and note-taking skills. • Technology skills including basic office equipment operation and proficiency with word processing and spreadsheet software. • High school