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)
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About the Role
The Compensation Specialist I plays a pivotal role in support the Human Resources team through compensation management and administering. This position involves responsibility for executing, maintaining, and analyzing compensation structures to ensure competitiveness and compliance with organizational policies and legal requirements. See below for more details.
Qualifications
· Bachelors Degree and 2 years of experience in Human Resources (healthcare or service organization experience preferred) as a Compensation Analyst/Specialist.
· Experience working with Compensation Management systems such as Workday, PayFactor , with strong skills in Excel.
· Must have advanced mathematical and analytical skills necessary to effectively gather, analyze and interpret data and policies, identify complex social, technical, and administrative problems and to develop an appropriate action plan for positive results.
· Demonstrated proficiency in creating extensive spreadsheets, word processing, proficiency in Excel, Word, PowerPoint and Workday preferred.
· Must have advanced written, verbal communication skills to develop correspondence, write policies and procedures, develop written communication tools, and provide regular and routine reports as required.
Responsibilities
· Acts as a resource to resolve complex problems and/or to recommend and implement improved systems/processes.
· Utilizes a variety of systems to organize, track, trend, and perform analysis and present information. Maintains accurate data and records to depict activities in areas of responsibility, prepares regular and special reports and analysis and submits to management as necessary or upon request.
· Participates in the development, implementation, communication and maintenance of plans, programs, and activities in area(s) of responsibility. Regularly monitors programs and activities to ensure they are in concert with Organizational and department objectives, goals, and philosophy. Provides the necessary data and analysis to support recommendations for change.
· Participates in developing, documenting, training, and implementing new Human Resource Compensation processes. Communicates processes to BHG management and employees where appropriate.
· Participates in developing, implementing, communicating, and administering the Organization's wage and salary programs.
· Performs analysis of current and proposed scenarios as necessary to determine appropriate range movement based upon internal equity and market trends. Gathers and interprets data from specified market areas. Matches positions, pay plans, and pay practices accurately, summarizes data collection and provides timely analysis of such in accordance with established procedures to provide appropriate recommendations for change and improvements within budgetary constraints of the Organization.
· Acts as a resource to management in the development of job descriptions and job analysis. Develops and maintains systems to ensure job descriptions are current and accurately depict job duties. Performs job analysis through interview with management, determines exempt/non-exempt status, and analyzes labor market data. Utilizes established procedures to recommend placement within wage and salary structures, submit for appropriate approval, and complete the procedures necessary to identify and place the position in the HR/Payroll systems and communicate changes to staff and management.
· Provides recommendation for increases within established procedures for hire, promotion, and demotion. Monitors new hire activity, changes of status, bonus recommendations and special requests to ensure accuracy and consistency in practices. Maintains appropriate tracking systems and prepares regular and special reports depicting activity.
· Upload and audit EIB/One Time Payment requests into Workday on a biweekly basis.
· Reviews position requests for placement on the agenda for Position Control Team meeting. Notifies appropriate constituents of the results of the meeting.
· Serves as Workday Governance compensation lead regarding testing and Workday releases.
· Cross-training to assist the Compensation Analyst and Compensation Manager as needed.
· Other duties as assigned.
Job Type: Full-time
Benefits:
Schedule:
Ability to Relocate:
Work Location: Hybrid remote in Kalamazoo, MI 49007
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