Reimbursement Specialist - Healthcare jobs in Jackson, MS

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)

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Quality specialist
  • AIS Healthcare
  • Ridgeland, MS FULL_TIME
  • At AIS Healthcare, we go beyond the expected, giving patients and providers more of what they need to thrive. Throughout our targeted drug delivery (TDD) and infusion care divisions, we’re committed to advancing quality and improving the lives of everyone we serve.

    At our state-of-the-art compounding pharmacies, we meet or exceed industry standards to produce medications of the highest quality and sterility.

    We take extra steps and make extra investments to ensure every person, every process and every protocol puts patient safety first.

    Inside our company, we are committed to respecting and empowering everyone who works with us, continually finding new ways to increase diversity and inclusion throughout our operations.

    We also invest in our communities, working to increase opportunity and reduce inequality through partnerships and social justice initiatives.

    The Quality Specialist position is responsible for assisting the Quality Manager in the implementation and management of the Quality Department.

    The Quality Specialist is also responsible for testing, observing processes, gathering, and analyzing data related to quality measures, investigating quality issues, assisting in the performance of root cause analyses, identifying training needs, and organizing training interventions to meet quality standards.

    This position organizes the data gathered in a meaningful way to interpret results and create initiatives.

    The typical hours for this position are 08 : 30 AM until 05 : 00 PM Monday through Friday.

    EDUCATION AND EXPERIENCE :

    Bachelor of Science or related field required; master’s degree preferred.

    Training and experience in quality or performance improvement strongly preferred with quality assurance or quality control experience required.

    Clinical, industrial, or analytical processes troubleshooting experience strongly preferred.

    ESSENTIAL DUTIES AND RESPONSIBILITIES :

    Works closely with the Quality Coordinator and may at times, carry out those duties which include, but are not limited to :

    Performs testing, including Environmental Monitoring, Air and Surface Sampling or other testing, as needed.

    Assists in performing employee competency checks including, garbing, hand hygiene, fingertip, and bubble pointing tests as needed.

    Performs reviews of equipment maintenance, validations, and other reviews as necessary.

    Understands and follows cleaning and disinfection procedures for all work areas.

    Assists in the media fill process validations to include inspection of filled units.

    Ensures personnel compliance with all quality programs.

    Informs management of critical compliance, regulatory or process findings or observations which may negatively impact quality assurance.

    Observes processes including, but not limited to, cleaning and environmental monitoring testing.

    Performs Root Cause Analysis assignments including the investigation, research, analysis, and documentation of the assignment.

    Creates and implements performance improvement initiatives.

    Completes thorough documentation of all assignments, including, but not limited to, testing, monitoring, sampling, observations, competencies, analyses, inspections, reviews, and initiatives related to quality control.

    industry standards, and other applicable regulations.

    Communicates and interprets quality guidelines effectively with coworkers and customers.

    Participates on project teams and provides necessary support to meet required deadlines, working with teams and partnering to facilitate continuous improvement.

    Reviews records, performs internal audits, desk audits, and recommends corrective action.

    Performs routine trend analysis, compiles information, and develops reports, as assigned.

    Provides training to all personnel to ensure all quality initiatives are properly understood and followed.

    Submits samples to the appropriate lab for testing and analysis.

    Maintains quality records. (Equipment calibration and maintenance, training, deviation and compliant investigation, environmental monitoring, Certificate of Analysis, clean room certifications, etc.)

    Writes, distributes, and maintains quality policies related to operations and production.

    Reviews the implementation and efficiency of quality systems.

    Serves as a resource to operations regarding equipment and facility validations, calibrations, and unexpected events.

    Serves as a liaison to Information Systems to facilitate innovation and continuous improvements in Quality Management Systems development.

    Works closely with the Quality Coordinator, under the direction of the Quality Manager.

    Recognizes patients’ rights and responsibilities and supports them in the performance of job duties, respects patient’s rights to privacy and confidentiality.

    Completes assigned paperwork / documents as directed in a timely manner.

    Shares knowledge gained with other staff members and works as a team member.

    Interacts with others in a positive, respectful, and considerate manner.

    Performs other job-related duties, as assigned.

    QUALIFICATION REQUIREMENTS :

    Required to take Quality Analyst, Quality Auditor, or a Six Sigma certification exam within 2 years of employment.

    Working knowledge of pharmaceutical processes.

    At least one year of working knowledge of quality assurance or quality control processes.

    Knowledge or ability to quickly learn commonly used concepts, practices and procedures within the pharmaceutical field.

    Excellent interpersonal skills, including strong communication skills.

    Strong analytical and problem-solving abilities.

    Ability to communicate effectively and professionally with coworkers across disciplines and with multiple levels of employees.

    Ability to work in a team environment, while also delivering independent results.

    Demonstrate extreme attention to detail and accuracy.

    Ability to prioritize and meet deadlines.

    Resourceful, flexible, and well organized.

    Advanced computer proficiency with the ability to work with IS to further develop databank needs.

    Knowledge of the use of Microsoft applications.

    STEPS TO APPLY :

    Complete the required Culture Index Candidate Assessment (Directions to follow below in this job posting, so please read in its entirety).

    No application will be considered if the applicant does not follow instructions and complete the assessment as part of the application process.

    Culture Index Candidate Assessment

    Why does AIS utilize the Culture Index Assessment?

    We recognize how important our employees are to the success of our company. Our company continues to thrive due to a culture of teamwork and our ability to match potential hires with positions that best utilize their natural traits and skillsets.

    AIS utilizes the Culture Index Candidate Assessment surveys to help us select the best match for our positions.

    How can I complete the assessment?

    Copy and paste the following link into your browser and press enter. Then, select the corresponding position for which you are applying.

    Only one assessment per candidate is required.) The assessment is brief, taking less than ten minutes to complete.

    portal.cultureindex.com / public / survey / general / 0BFB8F0000

    AIS HealthCare™ is the leading provider of advanced sterile, patient-specific intrathecal pump medications and in-home intravenous infusion, including immune globulin therapies.

    These services, combined with our advanced nursing and care coordination solutions, assist physicians and hospitals in delivering a superior level of care for optimal therapeutic outcomes.

    We offer a wonderful work culture, and we are looking for an impact player who is positive, earnest, and hardworking.

    Last updated : 2024-04-23

  • Just Posted

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Pharmacy Quality Specialist
  • AIS Healthcare
  • Ridgeland, MS FULL_TIME
  • At AIS Healthcare, we go beyond the expected, giving patients and providers more of what they need to thrive. Throughout our targeted drug delivery (TDD) and infusion care divisions, we’re committed t...
  • Just Posted

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Imaging specialist iii
  • Crothall Healthcare
  • Canton, MS FULL_TIME
  • Crothall Healthcare Salary : Other Forms of Compensation : Pay Grade : 8 Crothall Healthcare is a Compass One Company that provides specialized, high-quality, innovative, and responsive support servic...
  • Just Posted

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Experienced BCBS Insurance Collections Specialist
  • AIS HealthCare
  • Chunky, MS FULL_TIME
  • Recognizes patients' rights and responsibilities and supports them in the performance of job duties, respects patient's rights to privacy and confidentiality. Follows up on invoices submitted to ensur...
  • 1 Day Ago

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Pharmacy Quality Specialist
  • AIS Healthcare Career Center
  • Ridgeland, MS FULL_TIME
  • At AIS Healthcare, we go beyond the expected, giving patients and providers more of what they need to thrive. Throughout our targeted drug delivery (TDD) and infusion care divisions, we’re committed t...
  • 2 Days Ago

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Clinton Healthcare LPN position available
  • CLINTON HEALTHCARE
  • Clinton, MS FULL_TIME
  • Clinton Healthcare is a 121 bed facility located in Clinton MS. We are looking for a great LPN to join our amazing team. Competitive pay, with great shift differential. Weekend 8 hour days for part-ti...
  • 28 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Jackson, MS area

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Admin Support Assistant II
  • State of Mississippi
  • Jackson, MS
  • Salary: $24,023.49 Annually Location : 37 - LAMAR COUNTY, MS Job Type: Full-Time Job Number: 9023-0301-20240416LAM Depar...
  • 4/25/2024 12:00:00 AM

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Business Development Officer - Asset-Based Lending
  • UMB Bank
  • Jackson, MS
  • As the Business Development Officer - Asset-Based Lending , you will be responsible for originating loans consistent wit...
  • 4/24/2024 12:00:00 AM

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Senior Energy Economist
  • Cadmus
  • Jackson, MS
  • **Overview** **What Youll Be Doing** Cadmus seeks a senior consultant to join our Energy Services team as a Senior Energ...
  • 4/24/2024 12:00:00 AM

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Marketing Associate
  • Comarch S.a
  • Jackson, MS
  • This offer is outdated.See similar offers Areyou adynamic andresults-driven Marketing Associate looking foran exciting o...
  • 4/24/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Ridgeland, MS
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/23/2024 12:00:00 AM

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Security Officer III
  • State of Mississippi
  • Jackson, MS
  • Salary: $26,185.60 Annually Location : 37 - LAMAR COUNTY, MS Job Type: Full-Time Job Number: 9681-0372-20240411LAM Depar...
  • 4/23/2024 12:00:00 AM

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Senior Analyst, Energy Division – Survey and Evaluation Specialist
  • Cadmus
  • Jackson, MS
  • **Overview** **What Youll Be Doing** Cadmus seeks a survey and evaluation specialist to join the Market Research & Custo...
  • 4/21/2024 12:00:00 AM

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Field Reimbursement Specialist- Jackson, MS/ Shreveport, LA
  • Cencora
  • Jackson, MS
  • Our team members are at the heart of everything we do. At Cencora, we are united in our responsibility to create healthi...
  • 4/17/2024 12:00:00 AM

Jackson is located primarily in northeastern Hinds County, with small portions in Madison and Rankin counties. The Pearl River forms most of the eastern border of the city. A small portion of the city containing Tougaloo College lies in Madison County, bounded on the west by Interstate 220 and on the east by U.S. Route 51 and Interstate 55. An unconnected section of the city surrounds Jackson–Evers International Airport in Rankin County. In the 2010 census, only 622 of the city's residents lived in Madison County, and only 1 lived within the city limits in Rankin County. The city is bordered t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$40,047 to $48,663
Jackson, Mississippi area prices
were up 1.2% from a year ago

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