Skills & Competencies for Reimbursement Specialist - Healthcare

Reimbursement Specialist - Healthcare job profile

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JOB SUMMARY for Reimbursement Specialist - Healthcare

Determines the extent to which patients' insurance covers their treatments.

JOB RESPONSIBILITIES for Reimbursement Specialist - Healthcare

Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. 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.

Reimbursement Specialist - Healthcare SALARY RANGE

BASE 50%
$48,827
TOTAL 50%
$48,886
Job Level
P02
Job Code
HC07000294
Education/Degree
Bachelor's Degree
Reports To
Supervisor or Manager

Reimbursement Specialist - Healthcare Skills and Competencies List

Proficiency Levels and Behavioural Indicators
Salary.com identifies five increasing levels of proficiency for each skill/competency. Some jobs require only a relatively low level of proficiency in each skill/competency, while other jobs will require a more advanced level of proficiency in the same skill/competency. These levels rate the degree of proficiency (skill level, expertise) we expect the incumbent to perform in the given skill/competency for the given job. Note that we intentionally do not associate timeframes or years of experience in performing the skill/competency because that can be misleading. Proficiency levels identify what the incumbent knows and can do rather than how long they have been doing it. Also, note that the proficiency levels are cumulative, e.g., a level 4 proficiency implies the ability to perform all the behaviors at the lower levels.
Check each Reimbursement Specialist - Healthcare skill and competencie below to view definitions.
JOB FAMILY COMPETENCIES CORE COMPETENCIES
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9 general skills or competencies (Job family competencies) for Reimbursement Specialist - Healthcare

1 Job Family Competencies – Accounting
Proficiency Level -2
Skill definition-Creating financial statements and reports based on the summary of financial and business transactions.
Level 1 Behaviors
(General Familiarity)
Explains the basic concepts and major terminology of accounting.
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Level 2 Behaviors
(Light Experience)
Records financial transactions in the general ledger following accepted accounting principles.
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Level 3 Behaviors
(Moderate Experience)
Maintains consistency of accounts payable functions with sound accounting principles.
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Level 4 Behaviors
(Extensive Experience)
Leads the development of an accounting system to manage financial records and other information.
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Level 5 Behaviors
(Mastery)
Builds strong working relationships with business unit accounting teams.
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2 Job Family Competencies – Accounts Receivable
Proficiency Level -2
Skill definition-Monitoring and tracking the inflow of money yet to be paid by the customer.
Level 1 Behaviors
(General Familiarity)
Describes the basic concepts of accounts receivable.
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Level 2 Behaviors
(Light Experience)
Applies appropriate techniques in collecting accounts receivable.
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Level 3 Behaviors
(Moderate Experience)
Identifies client improvement opportunities for the client's accounts receivable.
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Level 4 Behaviors
(Extensive Experience)
Demonstrates advanced knowledge of the entire accounts receivable function.
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Level 5 Behaviors
(Mastery)
Establishes policies and procedures relating to all accounts receivable collections.
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3 Reimbursement Specialist - Healthcare - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Reimbursement Specialist - Healthcare
Proficiency Level - 4
5 Competency for - Reimbursement Specialist - Healthcare
Proficiency Level - 5

5 soft skills or competencies (core competencies) for Reimbursement Specialist - Healthcare

1 Core Competencies – Attention to Detail
Proficiency Level -2
Skill definition-Executing and completing a task with a high level of accuracy.
Level 1 Behaviors
(General Familiarity)
Cites steps and tips to improve attention to detail in the workplace.
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Level 2 Behaviors
(Light Experience)
Keeps full attention when listening to understand the message.
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Level 3 Behaviors
(Moderate Experience)
Balances between accuracy and efficiency for different tasks or programs.
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Level 4 Behaviors
(Extensive Experience)
Creates and implements quality management processes for our business.
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Level 5 Behaviors
(Mastery)
Defines possible hurdles to projects and creates strategies to deal with them.
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2 Core Competencies – Time Management
Proficiency Level -2
Skill definition-Managing and setting priorities, goals, and timetables to boost productivity and efficiency in completing tasks.
Level 1 Behaviors
(General Familiarity)
Cites examples of prioritization methods used to manage and save time in the workplace.
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Level 2 Behaviors
(Light Experience)
Adheres to schedules to allocate time for specific tasks efficiently.
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Level 3 Behaviors
(Moderate Experience)
Assesses relevance of tasks to prioritize and produce better quality work.
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Level 4 Behaviors
(Extensive Experience)
Creates programs to develop our employees' understanding of time demand and management.
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Level 5 Behaviors
(Mastery)
Builds a system to manage our business's workload and eliminate time-wasting activities.
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3 Reimbursement Specialist - Healthcare - Skill and Competency
Proficiency Level - 3
4 Skill and Competency - Reimbursement Specialist - Healthcare
Proficiency Level - 4
5 Competency for - Reimbursement Specialist - Healthcare
Proficiency Level - 5

Summary of Reimbursement Specialist - Healthcare skills and competencies

There are 0 hard skills for Reimbursement Specialist - Healthcare.
9 general skills for Reimbursement Specialist - Healthcare, Accounting, Accounts Receivable, Financial Reporting, etc.
5 soft skills for Reimbursement Specialist - Healthcare, Attention to Detail, Time Management, Initiative, etc.
While the list totals 14 distinct skills, it's important to note that not all are required to be mastered to the same degree. Some skills may only need a basic understanding, whereas others demand a higher level of expertise.
For instance, as a Reimbursement Specialist - Healthcare, he or she needs to be proficient in Attention to Detail, be proficient in Time Management, and be proficient in Initiative.

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