Reimbursement Specialist - Healthcare jobs in Fayetteville, AR

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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Medical Reimbursement Specialist
  • Washington Regional Medical System
  • Fayetteville, AR FULL_TIME
  • Position Summary

    The role of the Medical Reimbursement Specialist reports to the Director of Billing & Admissions, in partnership with the Dialysis CEO/Administrator. This position is responsible for for analyzing insurance documents, processing reimbursement claims, and releasing accurate billing statements for insurance claims. This position must possess excellent analytical skills, especially on performing clerical tasks to evaluate insurance cases, investigate cases, and update account information accordingly. This position must also possess consistent and effective communication skills and understanding of the insurance process in order to coordinate with the clients, explain procedures for claims accurately, and manage the insurance process for maintenance and improvement.


    Essential Position Responsibilities

    • Coordinate and manage resources, including primary and secondary third-party payers.
    • Obtain precertification and prior authorization for required medical services from third party payers.
    • Maintain a professional and confidential working environment.
    • Explain insurance benefits, policy requirements, and filing rules to patients.
    • Research and apply knowledge of all insurance rules and regulations for major insurance programs in the local or regional area.
    • Input and maintain patient data into appropriate database and ensure accuracy.
    • Ensure client confidentiality and compliance with HIPAA regulations.
    • Determine the protocol that identifies a responsible party’s monetary responsibility in health insurance claims.
    • Verify all patients insurances.
    • Obtain Authorizations as required by insurance carriers.
    • Collect all Co-pays, Coinsurance and Deductibles.
    • Back up for Medical Reimbursement Specialist II and Prior Authorization Specialist.
    • Other duties as assigned

    Qualifications

    • Education: High school diploma or GED, required
    • Licensure and Certifications: Certificate in Medical Coding and Billing or a Certified Medical Reimbursement Specialist preferred
    • Experience: Minimum of 3 years of medical office experience. Experience with working with third-party resources, including Medicare, Medicaid and private insurance, required. Previous insurance benefits, medical records and patient registration, required.


    Work Environment: This position will spend 80% of time sitting while performing work in a standard office environment and 20% of time standing and/or walking while pushing, pulling, lifting, and/or carrying up to 50 lbs.

  • 14 Days Ago

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Registered Nurse / Home Healthcare
  • Cross Country Healthcare
  • Fayetteville, AR FULL_TIME
  • Job DescriptionAs a home health nurse (RN HH), you will deliver healthcare in patients' residences, helping them maintain their independence. You will provide one-on-one care for patients in their hom...
  • 1 Day Ago

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Registered Nurse / Home Healthcare
  • Cross Country Healthcare
  • Grove, OK FULL_TIME
  • Job DescriptionAs a home health nurse (RN HH), you will deliver healthcare in patients' residences, helping them maintain their independence. You will provide one-on-one care for patients in their hom...
  • 25 Days Ago

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Project Superintendent (Healthcare)
  • Flintco
  • Springdale, AR FULL_TIME
  • Founded in 1908, Flintco now employs more than 800 people in 8 cities serving clients in healthcare, education, hospitality, sports and industrial. Flintco also self-performs concrete, steel erection ...
  • 13 Days Ago

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People Partner – Sam’s Healthcare
  • Sam's Club
  • BENTONVILLE, AR OTHER
  • Position Summary...What you'll do...About Walmart Global PeopleLeaders and individual contributors alike look to our Global People teams to influence strategy, optimize working models, and enable the ...
  • 11 Days Ago

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Workday Certified Financials Grants Lead - Healthcare
  • Hispanic Technology Executive Council
  • Bentonville, AR FULL_TIME
  • Workday Financials Healthcare Grants LeadWe are We are a global collective of innovators applying the New every day to improve the way the world works and lives. New doesnt mean being ahead of the cur...
  • 18 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Fayetteville, AR area

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CDL-A Truck Driver - Great Home Time - Competitive Pay
  • U.S. Xpress
  • Fayetteville, AR
  • U.S. Xpress is Now Hiring CDL-A Dedicated & OTR Drivers! Great Home Time - Competitive Pay - Excellent Benefits GREAT RO...
  • 3/28/2024 12:00:00 AM

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CDL-A Truck Driver - Great Home Time - Earn Up to $70k+/Year
  • U.S. Xpress
  • Fayetteville, AR
  • U.S. Xpress is Now Hiring CDL-A Dedicated & OTR Truck Drivers! Great Home Time - Competitive Pay - Excellent Benefits U....
  • 3/28/2024 12:00:00 AM

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CDL-A OTR Driver - Earn 45-60 CPM + Benefits
  • U.s. Xpress
  • Fayetteville, AR
  • U.S. Xpress is Now Hiring CDL-A OTR Solo Drivers! CDL-A Solo Drivers: Average 2,220+ Miles Per Week Earn 45-60 CPM Based...
  • 3/28/2024 12:00:00 AM

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LPN Admissions Specialist $8K Sign On
  • Acadia Healthcare Inc.
  • Fayetteville, AR
  • Overview FT Admissions LPN FT Days and Nights - 12 hour shifts. $8000 SIGN ON BONUS! Shift/Weekend Diffs up to ($5.50/hr...
  • 3/27/2024 12:00:00 AM

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Customer Service Specialist
  • Rollins, Inc.
  • Fayetteville, AR
  • ** Customer Service Specialist** **Job Category****:** Administrative **Requisition Number****:** CUSTO16193 Showing 1 l...
  • 3/27/2024 12:00:00 AM

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Field Service Coordinator
  • Chart Industries
  • Fayetteville, AR
  • Field Service Coordinator **Date:** Mar 5, 2024 **Location:** Work From Home, XX - Home Office, United States, n/a **Com...
  • 3/27/2024 12:00:00 AM

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Commercial Sales Manager
  • AutoZone, Inc.
  • Fayetteville, AR
  • The Commercial Sales Manager is responsible for driving the commercial sales within their AutoZone location. The CSM dev...
  • 3/26/2024 12:00:00 AM

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Member Support Associate (Work From Home)>
  • Modern Health
  • Fayetteville, AR
  • [Customer Service / Remote] - Anywhere in U.S. / Competitive Pay / Medical, Dental, Vision, Disability & Life Insurance ...
  • 3/24/2024 12:00:00 AM

Fayetteville is the third-largest city in Arkansas and county seat of Washington County. The city is centrally located within the county and has been home of the University of Arkansas since the institution's founding in 1871. Fayetteville is on the outskirts of the Boston Mountains, deep within the Ozarks. Known as Washington until 1829, the city was named after Fayetteville, Tennessee, from which many of the settlers had come. It was incorporated on November 3, 1836 and was rechartered in 1867. The four-county Northwest Arkansas Metropolitan Statistical Area is ranked 105th in terms of ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$41,273 to $50,152
Fayetteville, Arkansas area prices
were up 1.2% from a year ago

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