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)
Overview
Expected pay for this position is $37.99 - $44.70 / hour. Actual pay will be determined by experience, skills and internal equity.
POSITION SUMMARY : The Performance Improvement Specialist is responsible for supporting the management of multiple Performance Improvement projects from original concept through design and implementation, which are strategically focused and drive performance and financial results.
Responsible for completing workflow and application design, completing business assessments, developing and managing detailed project work plans, and implementing solutions for projects involving Performance Improvement activities.
Qualifications
REQUIRED QUALIFICATIONS :
Bachelor's Degree (BA or BS) with emphasis in Clinical, Business or Health Administration OR equivalent experience of at least 3 years in healthcare delivery and management, business or consulting* Experience with performance improvement methodologies and tools and / or project management
PREFERRED QUALIFICATIONS :
Experience in health care delivery* Experience in roles where key skills of critical thinking, problem solving, collaboration, relationship building and public speaking were needed
OSF HealthCare is an Equal Opportunity Employer.
Last updated : 2024-04-08
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