Reimbursement Specialist - Healthcare jobs in Toledo, OH

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)

U
Healthcare Compliance Specialist - Practice Plan - 496957
  • University of Toledo
  • Toledo, OH FULL_TIME
  • Job no: 496957
    Work type: Staff - Full-Time
    Location: Main Campus - Administration
    Categories: Full-Time, None, Compliance

    Title: Healthcare Compliance Specialist - Practice Plan

    Department Org: Internal Audit - 104920

    Employee Classification: U1 - Unclassified PSA FT

    Bargaining Unit: Professional Staff Association

    Primary Location: MC AD

    Shift: 1

    Start Time: 8:30am End Time: 5pm

    Posted Salary: $57,246- $71,526

    Float: No

    Rotate: No

    On Call: No

    Travel: No

    Weekend/Holiday: No

    Job Description:

    The Healthcare Compliance Specialist – Practice Plan is responsible for assisting with overseeing and guiding the Compliance Program for the Physicians Practice Plan (UTP). Duties include ensuring ethical and compliant practices are implemented and maintained across the organization in accordance with all applicable federal and state laws, regulations, ordinances, commercial payers’ rules and regulations internal policies and procedures, and other requirements as they relate to operations, billing, coding, proper payment, documentation practices, and the delivery of quality care in a compliant manner. This person oversees doing investigations in the field, working with general counsel, managing hotline calls, and managing risk as it related to compliance issues.

    Minimum Qualifications:

    Education/experience/licensing:
    • Must have a minimum of three (3) to five (5) years of experience in healthcare operations.
    • Bachelor’s degree preferred with emphasis on nursing – not required
    • Working knowledge of medical terminology, CPT, and ICD-10
    • A minimum of three (3) to five (5) years of experience as a certified physician coder preferred
    • RHIT, RHIA, or Certified Degree in Coding preferred
    Communication and other skills:
    • Must have demonstrated leadership skills, strong written and verbal communication skills, and ability to work independently.
    • Must have ability to escalate confidential and sensitive matters involving privacy and compliance.
    • Current knowledge of healthcare – federal and state privacy regulations and third-party regulations regarding medical record documentation
    • Must have ability to monitor advancements in information technology to ensure organizations adoption and compliance.
    • Strong positive verbal and written communication skills.

    Conditions of Employment:

    To promote the highest levels of health and well-being, the University of Toledo campuses are tobacco-free. To further this effort, the University of Toledo Health Science Campus Medical Center is requiring candidates for employment to be nicotine-free. Pre-employment health screening requirements will include cotinine (nicotine) testing, as well as drug and other required health screenings for the position. With the exception of positions within University of Toledo Main Campus and the University of Toledo College of Medicine and Life Sciences, the employment offer is conditional upon successful completion of a cotinine test and Occupational Health clearance.

    Equal Employment Opportunity Statement:

    The University of Toledo is an equal opportunity, affirmative action employer. The University of Toledo does not discriminate in employment, educational programs, or activities on the basis of race, color, religion, sex, age, ancestry, national origin, sexual orientation, gender identity and expression, military or veteran status, disability, familial status, or political affiliation.

    The University is dedicated to the goal of building a culturally diverse and pluralistic faculty and staff committed to teaching and working in a multicultural environment and strongly encourages applications from women, minorities, individuals with disabilities, dual-career professionals and covered veterans.

    The University of Toledo provides reasonable accommodation to individuals with disabilities. If you require accommodation to complete this application, or for testing or interviewing, please contact the Human Resources Department at 419-530-4747 between the hours of 8:30AM and 5:00PM or apply online for an accommodation request.

    Computer access is available at most public libraries and at the Office of Human Resources located in the Center for Administrative Support on the Main Campus of the University of Toledo.

    Advertised: 07 Mar 2024 Eastern Standard Time
    Applications close:

  • 8 Days Ago

C
Medical Records Specialist
  • Certus Healthcare
  • Toledo, OH FULL_TIME
  • Point Place Healthcare & Rehabilitation, owned and operated by Certus Healthcare, is seeking a Medical Records Specialist to join our team! We offer full benefits, 401K, tuition reimbursement and comp...
  • Just Posted

C
Medical Records Specialist
  • Certus Healthcare
  • Waterville, OH FULL_TIME
  • Heritage Village of Waterville, owned and operated by Certus Healthcare, is seeking a Medical Records Specialist to join our team! We offer full benefits, 401K, tuition reimbursement and competitive w...
  • 26 Days Ago

M
Intervention Specialist
  • Maxim Healthcare Staffing
  • Toledo, OH FULL_TIME
  • The Special Education Teacher, under the direction of the Special Education Program Administrator provides quality services to special education students, kindergarten through grade 12. The Special Ed...
  • 4 Days Ago

A
Medical Records & Central Supply Specialist
  • AOM Healthcare
  • Maumee, OH PART_TIME
  • AOM Healthcare is a premier long term care company, operating twenty one long term care facilities throughout the state of Ohio and is now hiring Part-Time Medical Records & Central Supply Specialist ...
  • 13 Days Ago

M
Intervention Specialist
  • Maxim Healthcare Staffing Services, Inc.
  • Toledo, OH OTHER
  • The Special Education Teacher, under the direction of the Special Education Program Administrator provides quality services to special education students, kindergarten through grade 12. The Special Ed...
  • 4 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Toledo, OH area

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Server
  • First Watch Restaurants, Inc.
  • Toledo, OH
  • Overview: Our YOU FIRST Philosophy In addition to no night shifts, ever and our fully chef-curated menu, our #1 priority...
  • 3/18/2024 12:00:00 AM

H
Prevention Education - Early Childhood Mental Health Specialist
  • Harbor, Inc.
  • Toledo, OH
  • Harbor is looking for a prevention educator who is proficient in early childhood mental health who will work in collabor...
  • 3/18/2024 12:00:00 AM

Z
Quality Supervisor
  • Zobility
  • Toledo, OH
  • Job Description: The Quality Supervisor is an integral part of a company whose focus is to change the automotive landsca...
  • 3/18/2024 12:00:00 AM

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Structural Engineer 5- Substation- US Hybrid
  • Black & Veatch
  • Toledo, OH
  • **Structural Engineer 5- Substation- US Hybrid** Date: Feb 22, 2024 Location: US Company: Black & Veatch Family of Compa...
  • 3/17/2024 12:00:00 AM

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CDL-A Truck Driver - Home Weekly - Average Up to $2,000+/Week = 401k
  • KAG Specialty Products - Toledo, OH
  • Harbor View, OH
  • KAG Specialty Products is now hiring Regional CDL-A Drivers - Toledo, OH Average Up to $2,000+ Weekly - Home Weekly - Ex...
  • 3/17/2024 12:00:00 AM

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CDL-A Truck Driver - Home Weekly - Average Up to $2,000+/Week = 401k
  • KAG Specialty Products - Toledo, OH
  • Rossford, OH
  • KAG Specialty Products is now hiring Regional CDL-A Drivers - Toledo, OH Average Up to $2,000+ Weekly - Home Weekly - Ex...
  • 3/17/2024 12:00:00 AM

K
CDL-A Truck Driver - Home Weekly - Average Up to $2,000+/Week = 401k
  • KAG Specialty Products - Toledo, OH
  • Toledo, OH
  • KAG Specialty Products is now hiring Regional CDL-A Drivers - Toledo, OH Average Up to $2,000+ Weekly - Home Weekly - Ex...
  • 3/17/2024 12:00:00 AM

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Structural Engineer 5- Transmission Line- US Hybrid
  • Black & Veatch
  • Toledo, OH
  • **Structural Engineer 5- Transmission Line- US Hybrid** Date: Feb 22, 2024 Location: US Company: Black & Veatch Family o...
  • 3/15/2024 12:00:00 AM

Toledo (/təˈliːdoʊ/) is a city in and the county seat of Lucas County, Ohio, United States. Toledo is in northwest Ohio, at the western end of Lake Erie bordering the state of Michigan. The city was founded in 1833 on the west bank of the Maumee River, and originally incorporated as part of Monroe County, Michigan Territory. It was re-founded in 1837, after conclusion of the Toledo War, when it was incorporated in Ohio. After the 1845 completion of the Miami and Erie Canal, Toledo grew quickly; it also benefited from its position on the railway line between New York City and Chicago. The first...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$43,778 to $53,195
Toledo, Ohio area prices
were up 1.3% from a year ago

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