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)
Job Description:
Provides shift/per-visit skilled nursing services to agency patients.
Provides assessment of newly referred patients, assesses health needs and eligibility for home care.
Provides patient and family teaching prior to discharge and on an on-going basis.
Performs patient assessments and reassessments in the home.
Provides skilled nursing on assigned patients according to medical orders, and policies and procedures in accordance with the RN Scope of Practice.
Communicates with referrers/discharge planners to review eligibility for agency services and to develop and coordinate the plan of care.
Develops and implements treatment plans in conjunction with the patient’s authorized medical practitioner, communicating changes in patient condition, treatments and care to the Director of Home Care Services and other members of the healthcare team.
Administers medication as ordered by the patient’s physician.
Reassesses patient’s needs for services on a continual basis and discusses any changes in the plan.
Prepares written documentation and summaries of the patient’s progress as needed for continuation of home health services.
Plans, facilitates, and documents patient’s discharge from the agency.
Communicates changes in the patient’s condition/home environment, social structure etc. to the agency’s DHC.
Attends professional and required in-service programs annually.
Participates in the agency CQ/PI Program, as requested.
Other assignments within the RN Practice Act.
All nurses are required to be vaccinated and follow proper OSHA protocols.
Job Types: Full-time, Part-time, Contract, PRN, Permanent, Per diem, Temporary
Pay: $46.00 - $52.00 per hour
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Work Location: On the road
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0 Reimbursement Specialist - Healthcare jobs found in New Suffolk, NY area