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)
Description
Job Grade: 4
Purpose of job:
The Reimbursement Specialist is responsible for managing outstanding worker’s compensation claims by collecting payments, resolving billing issues, and minimizing the number of uncollectable accounts. The ideal candidate will be results-driven and able to focus on key performance metrics to ensure quality and efficiency standards set forth by the company are met.
Main Duties
- Reduce the number of past due accounts through timely follow-up;
- Reduce the number of past due accounts through escalation and claim resolution;
- Increase cash performance through effective and persuasive collection attempts;
- Reduce the number of days in AR for uncollectable accounts
Requirements
Qualifications:
Knowledge, Skills and Abilities:
Clear All
0 Reimbursement Specialist - Healthcare jobs found in Birmingham, AL area