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)
Responsible for ensuring optimal and timely reimbursement by maintaining accurate client eligibility information, resolving errors before claims are filed, and following up on claims, denials, payer correspondence, and authorizations. Work closely with the Reimbursement Supervisor to improve processes, efficiencies, and productivity.
Requirements: Requires High School diploma or equivalent. Preferably a minimum of two years in Medicare, Medicaid and other third party billings within an outpatient behavioral health setting. Knowledge and understanding of HIPAA laws and client privacy. Proficient in communication, customer service, internal and external and the ability to manage time. Strong organizational skill and detail oriented is a must. Ability to function independently, and work well with others. Must be efficient, timely and accurate in all duties and responsibilities. Must conduct self professionally, maintain confidentiality, and have strong computer skills.
0 Reimbursement Specialist - Healthcare jobs found in Tulsa, OK area