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)
Expected pay for this position is $28.44 - $33.46/hour. Actual pay will be determined by experience, skills and internal equity.
POSITION SUMMARY: The Reimbursement Data Analyst II is primarily responsible for ensuring accurate and timely payor reimbursement coding for assigned OSF hospitals and other entities in the electronic medical record system. This includes, but is not limited to the following: education, training and oversight of department staff on contract coding in the electronic medical record system, auditing department staff on contract coding, coordination and reporting between OSF HealthCare facilities, report writing, assists in contract modeling, and ongoing contract maintenance in OSF's electronic medical record system.
REQUIRED QUALIFICATIONS:
Other Skills/ Knowledge:
PREFERRED QUALIFICATIONS:
OSF HealthCare is an Equal Opportunity Employer.
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