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)
Apple Homecare Medical, in collaboration with Pediatric Home Service, is a friendly and professional leader in home health industry with a singular passion for and commitment to taking care of the child. As a leader in home health care, we help kids achieve their best lives at home and in their communities while providing our employees a fun and rewarding place to work.
THE POSITION:
Our company is a long-established pediatric medical supplies provider and recognized leader in the industry with multiple locations throughout Texas. The successful candidate will be self motivated and have experience in EOB, determining underpayments, filling reconsiderations and appeals with various governments and commercial payers, ailing with claim-related duties.
THE QUALIFICATIONS:
THE COMPANY
Apple Homecare Medical in collaboration with Pediatric Home Service is a pediatric home health agency that has provided high quality DME and nursing services to children that are medically fragile. Our services allow our clients to remain and thrive in their homes, schools, and communities.
THE BENEFITS
Interested candidates should apply online at, please include cover letter & resume along with salary requirements in your application.
Pediatric Home Service is an equal opportunity employer; we are committed to affirmative action and equal employment opportunities for all regardless of protected veteran status, race, color, creed, religion, national origin, sex, sexual orientation or identity, disability, age, marital status, familial status, membership or activity in a local human rights commission, or status with regard to public assistance.
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