Jan 18, 2022

Provider Reimbursements Representative Houston, TX, US

  • Veterans Evaluation Services, Inc
  • Houston, TX
Full-Time Accounting Administration Defense Finance Other

Job Description

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https://workforcenow.adp.com/mascsr/default/mdf/recruitment/recruitment.html?cid=72342c9d-787d-4dff-a51f-0e6000455a1e&ccId=19000101_000001&type=MP&lang=en_US

Provider Reimbursements Representative

Houston, TX, US5 days agoRequisition ID: 1818

General Job Summary:

The Provider Reimbursements team works closely with our providers to establish good rapport and to answer their inquiries with regard to DBQs, travel pay, contractual agreements, and pay rates. They work with providers to help them understand their contracts with VES and VES’ own contract with VA. As needed they will direct provider calls to other departments or members of other departments to assist with resolution of non-payment requests.

Provider Reimbursements will issue bonus requests, rate increases and other fees as required. Provider Reimbursements issues reimbursement for travel expenses incurred, communicates VES’ policies regarding travel, and approves travel overages as needed.

Provider Reimbursements supports Credentialing and Recruitment teams by helping to facilitate completion of provider rate updates, etc. As needed, Provider Reimbursements will assist with 1099 questions and dispersal, and answer general tax related questions.

Additionally, Provider Reimbursements will complete all other projects as requested by management.

Essential Job Functions:

1)    Provider Reimbursements must be well versed in VES contracts and able to explain and negotiate contracts with our providers;
2)    Negotiates rates with our provider network; Reimbursements should be able to assess a number of factors when considering rates, including provider timeliness, report quality, history with the company, and any outlying circumstances;
3)    Negotiates provider bonuses as applicable and issues bonus requests; when considering bonuses, Reimbursements team should be able to assess a variety of factors, including the size and approximate difficulty of a given case, any differences in regional pricing which may factor in, and any prior payment agreements which we may have with the provider;
4)    Reimburses travel expenses for VES related work and conveys VES policies re: travel to providers; Provider Reimbursements should communicate with Regional Operations Managers and scheduling leadership to assess VES’ needs which necessitated travel and to discuss any other challenges related to provider travel.
5)    Explains in detail our provider contracts and billing procedures as needed;
6)    Assists Billing team with provider inquiries into past payments;
7)    Assists Accounting by answering provider questions on 1099s and tax issues, and with dispersal of 1099s as needed;

Additional Duties and Responsibilities:

1)    Assist providers with any and all questions related to payment;
2)    Reliably route providers to the proper department or person when assisting with non-payment related issues;
3)    Attend biweekly team meetings;
4)    Other duties as assigned by management;

Knowledge/Skills/Abilities:

1)    Self-starter;
2)    Intermediate knowledge of pertinent medical terminology;
3)    Advanced verbal and interpersonal skills;
4)    Advanced written communication skills, to include excellent grammar;
5)    Advanced reading and comprehension abilities;
6)    Advanced analytical skills and detail-oriented;
7)    Advanced multi-tasking skills;
8)    Advanced organizational and prioritization skills, with strong ability to meet strict deadlines with minimal supervision;
9)    Proficient typing skills; and
10)    Proficient with Microsoft Word, Microsoft Outlook, Adobe Acrobat, general internet research, and beginner knowledge of Microsoft Excel.

Working Conditions:

1)    Casual office environment, with some exposure to mild noise from office equipment and moderate noise generated by staff members; and
2)    Frequently utilizes phone, fax machine, computer, printer, and copy machines.

Minimum Level of Preparation and Training:

1)    Bachelor’s degree or equivalent experience required.

States

TX

Security Clearance

NO Security Clearance

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