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3.3 | Andover, MA | Hospital & Health Care | 10000+ Employees
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Posted a month ago on Jan. 9, 2020

Medical Revenue Cycle Specialist

Full-time in Plymouth, MN
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Paid Time Off
Flexible Work Hours
Ability to Telecommute
Wellness Initiatives
The People You Work With
Philips is a hospital & health care company headquartered in the Andover, MA area with 10000+ employees. Philips has a 3.3-star InHerSight Score, based on 1,117 ratings from 78 current or former employees. 23 employees have left comments about their experience working for the company on InHerSight.

Job Title

Medical Revenue Cycle Specialist

Job Description

The Reimbursement Specialist is responsible for the accurate and efficient follow up and resolution of outstanding claims from insurance carriers, third party agencies and patients. The Reimbursement Specialist will coordinate, document, and communicate with health insurance representatives regarding proper insurance payments in accordance with policies and procedures, current federal, state and local and standards, guidelines, and regulations.  The Reimbursement Specialist will assist the leadership on key reimbursement projects.


  • Responsible for accurate and timely collecting of billed and unpaid DME claims related to Commercial, Federal and State insurance plans and private pay accounts; monitor and minimize aged accounts receivables; ensure follow up on claims is within payer turn-around-time standards
  • Obtain and track claim status via phone and online portals
  • Monitor, take action and respond to claims related correspondence
  • Compose and follow up on claims appeals within specified payer timelines and protocals
  • Appropriately identify, address, submit or process adjustments, overpayments, and outstanding balances
  • Review and respond to payment information associated with Explanation of Benefits or Remittance Advice documents
  • Build relationships with insurance carriers and representatives
  • Updates claims related to change of insurance
  • Performs other duties as requested by supervisor or manager
  • Reviews and release rental agreement hold
  • Communicating with patients regarding outstanding balances
  • Communicate and collaborate with the internal departments
  • Maintains strict confidentiality of patient personal information
  • Maintains HIPPA compliance
  • Understands business implications of decisions
  • Performs other duties as requested by supervisor or manager
  • Reviews, understands and follows department policies, Standard Operating Procedures (SOPs) and job aides
  • Notifies Supervisor and Manager of any defects or enhancement opportunities for SOPs and job aides
  • Assists with annual review of SOP’s and job aides
  • Assists peers in answering processing questions and assists in training new hires
  • Assumes responsibility for reimbursement related special tasks or assignments
  • Serves as subject matter expert in the absence of the supervisor
  • Collaborates with external and internal team members and customers to create a positive experience for customers and minimizes days sales outstanding (DSO) and denials and maximizes cash collections


  • Bachelor’s degree or equivalent work experience or combination of secondary education and work experience in a healthcare related setting
  • A minimum of four years of direct work experience related to medical claims billing/collections, insurance, appeals, authorizations
  • Durable Medical Equipment (DME) claim processing experience  preferred
  • Demonstrated superior customer service skills
  • Proven excellent verbal and written communication skills
  • Strong computer skills, including word processing and spreadsheet software

In return, we offer you

Sharpen your talents with new challenges in our dynamic organization. As a market-driven company, we’re used to listening to our customers & apply the same thinking to our employees. We offer a competitive salary, outstanding benefits and flexibility in a career with a positive and supportive atmosphere in which to develop your talents further.

Why should you join Philips?

Working at Philips is more than a job. It’s a calling to create a healthier society through meaningful work, focused on improving 3 billion lives a year by delivering innovative solutions across the health continuum. Our people experience a variety of unexpected moments when their lives and careers come together in meaningful ways.

To find out more about what it’s like working for Philips at a personal level, visit the Working at Philips page on our career website, where you can read stories from our employee blog. Once there, you can also learn about our recruitment process, or find answers to some of the frequently asked questions.

It is the policy of Philips to provide equal employment and advancement opportunities to all colleagues and applicants for employment without regard to age, color, citizenship, disability or perceived disability, ethnicity, gender, gender identity or expression, genetic information, marital or domestic partner status, military or veteran status, national origin, pregnancy/childbirth, race, religion, sexual orientation, or any other category protected by federal, state and/or local laws.  Philips is an equal employment opportunity and affirmative action employer Disability/Veteran.

As an equal opportunity employer, Philips is committed to a diverse workforce. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants that require accommodation in the job application process may contact 888-367-7223, option 5, for assistance.


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