Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
JOB SUMMARY: Responsible for maximizing reimbursement, including Payor Contracts. Overall responsibility for current processes and future adaptability to changes in healthcare reimbursement. Management of all business office functions. Ensures compliance with all organizational and regulatory standards related to governmental and third-party payor requirements. Oversee the reimbursement of multi-site skilled nursing facilities.
Minimum Job Qualifications:
Experience:
Education: Bachelors Degree or equivalent experience.
ESSENTIAL FUNCTIONS and QUALITIES:
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0 Reimbursement Specialist - Healthcare jobs found in Asheville, NC area