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)
Summary
Position Summary
The Patient Access Specialist position receives, coordinates and implements the initial patient experience by providing critical functions essential to ensuring proper clinical treatment, billing and reimbursement, patient satisfaction as well as efficient and accurate handling of the patient registration process.
Minimum Requirements
Education
High School diploma or equivalency
Experience
License / Registration / Certifications
N / A
Preferred Requirements
Preferred Education
Associates or bachelor’s degree in Business or Healthcare related field
Preferred Experience
Preferred License / Registration / Certifications
Certified Healthcare Access Associate (CHAA) or Certified Medical Insurance Specialist (CMIS)
Core Job Responsibilities
Last updated : 2024-04-19
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