Trauma Reimbursement Analyst I


Medical and Nursing

Advert ID




Job Type




Salary Range

Based on Experience

No. of Openings


Branch Information

Columbus, GA - (USA) 1648 Whittlesey Road Suite 100 GA Columbus , GA 31904



Job Description

Trauma Reimbursement Analyst

Position Goal:

Maintains overall understanding of assigned payor to include CMS regulations and billing requirements. Serves as a liaison between clinic and assigned payor.


1 year experience required (2 years preferred) of medical collections experience that demonstrates the following: insurance/claims processing, posting, modifier use, understanding of EOB's, navigation of payor sites, HCFA\UB, determining eligibility/co-insurance/ copayments and deductibles. Must have knowledge of front end (patient payments, demographic to file the claim) and back office billing office practices (the filing and follow up of the claim). Physician practice setting preferred. CPAR preferred.


* Organizes clinic claims for electronic or hard copy mail and ensures expected receipt by appropriate third party payors.

* Reviews claims to ensure payor specific billing requirements are met, follows up on billing, determines and applies appropriate adjustments, answers questions and updates accounts as necessary.

* Manage assigned Payor buckets.

* Ensures timely filing/follow up requirements followed by payor

* Assist patients with questions/payments on their accounts.

* Appropriately appeal insurance claims in a timely manner.

* Review operative and consult notes to support proper billing.

* Research and write up refunds in a timely manner.

* Minimize Days in Accounts Receivable.

* Establish /maintain relationships with Trauma Clinical Staff.

* Vast understanding of State Law Medical Billing Requirements.

* Communicate and management of Out of State billing policies.

* Obtain hospital authorizations when needed for inpatient claims

* Assist patients with arrangement of payment plans for outstanding balances as outlined by clinic policies.

* Collect monies owed by patients using Athena tools in accordance with all applicable accounting and financial policies.

* Processing and posting of verbal payments

* Processing and posting of Virtual Payments

* Maintain Unpostable Dashboard

* Educate assigned front desk staff regarding billing issues

* Performs other duties as assigned by Management.