Reimbursement Specialist - Healthcare jobs in Philadelphia, PA
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)
Recently Added Reimbursement Specialist - Healthcare jobs
Regional Clinical Reimbursement Specialist (RCRS)
- Saber Healthcare
-
Philadelphia, PA
FULL_TIME
-
Caring is at the heart of everything! Working in long term care offers many rewards you can’t find anywhere else. From the relationships you develop to the sense of pride you feel when you help others, you can find it here! Come work for a team that goes the extra mile to make a difference in the lives of others!
We offer everything you are looking for: On Demand Pay * Excellent PTO program * Great health plans * Employee Engagement Activities * Growth Opportunities *Company paid life insurance & much more!
If you’re interested in making a difference in the healthcare field, explore the current job opportunities available. You’ll be able to make a difference in the lives of the residents as well as their families and friends.
POSITION SUMMARY:
As Regional Clinical Reimbursement Specialist, you are delegated the administrative authority and accountability necessary for carrying out your assigned duties. You are responsible for the functions of the reimbursement department at each facility in your region. This position assumes a primary role in RAI process.
Qualifications/Responsibilities:
- Must possess a current, unencumbered, active license to practice as a Registered Nurse or Licensed Practical Nurse in the state of employment.
- Implements policies and procedure for Clinical Reimbursement in the Region
- Monitors achievement of goals and objectives for the facility in regard to clinical assessments and reimbursement consistent with established philosophy and standards of practice
- Monitors Quality Indicators and Quality Measures to ensure the appropriate information within the MDS assessments is accurately identified.
- Conducts facility reviews to assure the facility is in compliance with timeframes and accuracy of the MDS.
- Assure care planning and care conferencing is taking place according to the state and regulatory guidelines.
- Schedules periodic site visits to provide supervision, clinical expertise, ensure communication and to monitor the overall operation of reimbursement department.
- Provide in-service training and orientation to facility staff regarding the MDS, ADL’s and accuracy.
- Must have proven leadership ability with a minimum of one (1) year of experience in nursing service administration.
Benefits and Perks*:
- Eligible for benefits the first of the month following 30 days
- Employer contribution and match for HSA (Health savings account)
- Comprehensive benefit packages including medical, dental and vision
- 401K through Fidelity
- Paid Time Off (PTO)
- Educational and tuition opportunities
- Employee Assistance Program (EAP) with various discount programs offered
- Wellness programs available through WebMD
- Employee Recognition Programs
- Making an IMPACT!
- Program details can vary amongst buildings. Please see HR for the facility-specific benefit plans.
- 1 Month Ago
Reimbursement specialist
- Syneos Health/ inVentiv Health Commercial LLC
-
Philadelphia, PA
FULL_TIME
- Description You are an expert facilitator : you open doors, foster communication, and bridge the gap. In this role, you will be responsible for the management of defined accounts in a specified geogra...
- Just Posted
Reimbursement Specialist
- Synergy Orthopedics
-
Plymouth Meeting, PA
FULL_TIME
- Job Description Job Description Objective : The Reimbursement Specialist will be expected to follow up on open claims and maintain patient information. The individual will also process denials and app...
- 28 Days Ago
Medicaid Reimbursement Nurse - RN
- Genesis HealthCare - Wyncote, PA
-
Wyncote, PA
FULL_TIME
- Genesis HealthCare is one of the nation's leading providers of healthcare services from short-term to long-term care and a wide variety of living options and professional clinical services. We are cha...
- 21 Days Ago
Field Reimbursement Specialist
- Syneos Health/ inVentiv Health Commercial LLC
-
Philadelphia, PA
FULL_TIME
- Description You are an expert facilitator: you open doors, foster communication, and bridge the gap.In this role, you will be responsible for the management of defined accounts in a specified geograph...
- Just Posted
Field Reimbursement Specialist
- Syneos Health Commercial Solutions
-
Philadelphia, PA
FULL_TIME
- Description You are an expert facilitator: you open doors, foster communication, and bridge the gap. In this role, you will be responsible for the management of defined accounts in a specified geograp...
- 1 Month Ago
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0 Reimbursement Specialist - Healthcare jobs found in Philadelphia, PA area
About Philadelphia, Pennsylvania
Philadelphia, sometimes known colloquially as Philly, is the largest city in the U.S. state and Commonwealth of Pennsylvania, and the sixth-most populous U.S. city, with a 2017 census-estimated population of 1,580,863. Since 1854, the city has been coterminous with Philadelphia County, the most populous county in Pennsylvania and the urban core of the eighth-largest U.S. metropolitan statistical area, with over 6 million residents as of 2017[update]. Philadelphia is also the economic and cultural anchor of the greater Delaware Valley, located along the lower Delaware and Schuylkill Rivers, wit...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$47,570 to $57,804
Philadelphia, Pennsylvania area prices
were up 1.0% from a year ago
were up 1.0% from a year ago
What does a Reimbursement Specialist - Healthcare do?
Reimbursement Specialist - Healthcare in Anchorage, AK
Bureau of Labor Statistics, occupations and industries related to healthcare are projected to add more new jobs to the U.S.
December 07, 2019
Reimbursement Specialist - Healthcare in Brownsville, TX
You will also be notified when something of note is happening around the Coding and Reimbursement Specialist program.
January 26, 2020
Reimbursement Specialist - Healthcare in Charlotte, NC
MedCert’s Reimbursement and EHR Specialist Certification program is well rounded and features 24/7 access to the curriculum with video and course content, program supplements, and all the resources your need for successful independent study.
January 08, 2020