Reimbursement Services Specialist

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Reimbursement Services Specialist processes reimbursement transactions to ensure accurate and timely payment, adjustment, and reconciliation of claims. Reviews claim and payment information to verify policy details, validate charges and coding, and ensure claim accuracy and completeness. Being a Reimbursement Services Specialist coordinates with payers, providers, and internal departments to resolve reimbursement issues. Develops and generates reports on claim statuses, reimbursement trends, and denial patterns to identify opportunities for process improvements. Additionally, Reimbursement Services Specialist ensures compliance with applicable laws, payer requirements, and company guidelines. Requires an associate degree. Typically reports to a manager. The Reimbursement Services Specialist occasionally directed in several aspects of the work. Gaining exposure to some of the complex tasks within the job function. To be a Reimbursement Services Specialist typically requires 2-4 years of related experience.