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)
This position requires an advanced understanding of records, coding, and billing practices to ensure compliance and patient confidentiality. If you want to be in a medical setting where you don’t have to be up and running, becoming a reimbursement specialist may be the right career for you. If you have been in a previous insurance role and have strong organization skills, you may be the perfect candidate to fulfill our open position as a reimbursement special
This position performs moderately complex bookkeeping, recordkeeping, and insurance claim billing activities. Responsibilities include payment posting, work denials and appeals for Medicaid, Medicare, Managed Care Organizations and Private Insurance. Attends required training and meetings.
Duties and Responsibilities:
Education and Experience:
Preferred Qualifications: Five or more years of work experience processing insurance claims for health-related accounts and collection work.
Knowledge, Skills & Abilities:
Work Schedule: 8-5 (Mon-Fri) Flex
Salary Range: $18-$22 (Depending on Experience/Qualifications)
Employee Benefits at Full-Time Include:
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