Reimbursement Specialist - Healthcare jobs in Pennsylvania
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
Payment/Reimbursement Specialist - 7038
- Penn Highlands Healthcare
-
Du Bois, PA
FULL_TIME
-
Penn Highlands Healthcare has been awarded on the Forbes list of Best-in-State Employers 2022. This prestigious award is presented by Forbes and Statistica Inc., the world leading statistics portal and industry ranking provider.
Summary
AS A PAYMENT/REIMBURSEMENT SPECIALIST, YOU'LL WORK WITH CLINICAL DOCUMENTATION AND FACILITY INFORMATION SYSTEMS TO EXTRACT THE DATA NECESSARY TO PERFORM ONGOING ANALYSIS OF PATIENT ACCOUNT-BASED REIMBURSEMENT TRANSACTIONS FOR ACCURACY. ANALYZES FACILITY MANAGED CARE CONTRACTS AND RECONCILE TO PATIENT CARE INFORMATION TO DETERMINE ACCURACY OF PAYMENTS RECEIVED TO CODES BILLED. CONTACTS INSURANCE COMPANIES TO HAVE ADJUSTMENTS PROCESSED IF PAYMENTS ARE NOT IN ACCORDANCE WITH THE CONTRACT. EVALUATES ACCURACY OF CODE SELECTION TO SERVICES PERFORMED. WORKS WITH ANCILLARY CLINICAL STAFF TO PROVIDE DEPARTMENTAL PROCESS IMPROVEMENTS IN DOCUMENTATION AND CHARGE CODE SELECTION. MAKES RECOMMENDATIONS TO PREVENT FUTURE LOSSES. PROVIDES INFORMATION TO ASSIST FACILITY IN MANAGED CARE CONTRACT NEGOTIATIONS.
Qualifications
Other information:- BACHELOR DEGREE IN HEALTHCARE RELATED FIELD REQUIRED. RELATED WORK EXPERIENCE MAY BE ACCEPTED IN LIEU OF EDUCATIONAL REQUIREMENT.
- CLINICAL OR CODING EXPERIENCE HIGHLY PREFERRED; EXPERIENCE WITH CERNER EMR AND/OR CERNER PATEINT ACCOUNTING HIGHLY PREFERRED
- STRONG QUANTITATIVE, ANALYTICAL, AND ORGANIZATION SKILLS.
- ABILITY TO UNDERSTAND MEDICAL RECORDS, HOSPITAL BILLS, CHARGE MASTER, ANCILLARY DEPARTMENT FUNCTIONS, COMPLEX INSURANCE TERMS AND PAYMENT METHODOLOGIES.
- EFFECTIVELY NEOGTIATE WITH INSURANCE CARRIERS AND CUSTOMERS.
- UNDER STAND COMPUTER TECHNOLOGY.
- EXPERIENCE WORKIGN WITH MICROSOFT OFFICE SUITE OF PRODUCTS.
- CURRENT KNOWLEDGE OF REVENUE CYCLE PROCESSES, HOSPITAL/MEDICAL BILLING, CPT CODES, HCPCS CODES, ICD-10, NCCI EDITS, MEDICARE REGULATIONS, INCLUDING LCD/NCD’S AND MANAGED CARE CONTRACTS.
- Competitive Compensation
- Shift Differentials
- Tuition Reimbursement
- Professional Development
- Supportive and Experienced Peers
- Medical, Dental, and Vision offered after completion of introductory period
- Paid Time Off
- 403(b) retirement plan with company match
- Company Paid Short & Long Term disability coverage
- Company Paid and Voluntary Life Insurance
- Flex Spending Account
- Employee Assistance Program (EAP)
- Health & Wellness Programs
- 7 Days Ago
Regional Clinical Reimbursement Specialist (RCRS)
- Saber Healthcare
-
Allentown, 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...
- 28 Days Ago
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...
- 28 Days Ago
Reimbursement Specialist
- Zoll Medical Corporation
-
Pittsburgh, PA
FULL_TIME
- Reimbursement Specialist Location: Pittsburgh, PA, United States of America Cardiac Management Solutions At ZOLL, we're passionate about improving patient outcomes and helping save lives. We provide i...
- 7 Days Ago
Reimbursement Specialist
- Synergy Orthopedics, LLC
-
Plymouth Meeting, PA
FULL_TIME
- Job DescriptionObjective:The Reimbursement Specialist will be expected to follow up on open claims and maintain patient information. The individual will also process denials and appeals to assure coll...
- 12 Days Ago
Reimbursement Specialist
- The Judge Group
-
Plymouth Meeting, PA
FULL_TIME
- This job offer is not available in your country. Our client is currently seeking a Reimbursement Specialist The Reimbursement Specialist will be expected to follow up on open claims and maintain patie...
- 19 Days Ago
Reimbursement Specialist - Healthcare jobs at Popular Companies
Reimbursement Specialist
- Randstad Life Sciences
-
Tempe, AZ
- Job Description Job Description Job Description Provides mission critical support to company brands by helping patients ...
- 6/11/2024 12:00:00 AM
Reimbursement Specialist
- Randstad Life Sciences
-
Tempe, AZ
- Job Description Job Description Job Description The Reimbursement Specialist will be responsible for providing support a...
- 6/11/2024 12:00:00 AM
Coding and Reimbursement Specialist
- Howard University
-
Washington, DC
- The Talent Acquisition department hires qualified candidates to fill positions which contribute to the overall strategic...
- 6/11/2024 12:00:00 AM
Reimbursement Specialist
- Synergy Orthopedics
-
Plymouth Meeting, PA
- Job Description Job Description Objective: The Reimbursement Specialist will be expected to follow up on open claims and...
- 6/10/2024 12:00:00 AM
Reimbursement Specialist
- Randstad Life Sciences
-
East Hanover, NJ
- Job Description Job Description Title: Reimbursement Specialist 1 Duration: 6 months Pay Rate : $27.50/hr on W2 Location...
- 6/10/2024 12:00:00 AM
Reimbursement Specialist
- Prompt Care Companies Inc
-
New Providence, NJ
- Job Type Full-time Description PromptCare is seeking a highly motivated and detail-oriented Reimbursement Specialist to ...
- 6/8/2024 12:00:00 AM
Reimbursement Specialist
- University Health System- San Antonio
-
San Antonio, TX
- POSITION SUMMARY/RESPONSIBILITIES Identifies and enrolls indigent and under-insured patients into drug assistance reimbu...
- 6/8/2024 12:00:00 AM
Reimbursement Specialist
- Vinfen
-
Cambridge, MA
- Schedule: Mon-Fri 9am-5pm (2 days remote after training) Salary: $23.00-$25.00 / hour The Reimbursement Specialist is ch...
- 6/8/2024 12:00:00 AM
About Pennsylvania
Pennsylvania (/ˌpɛnsɪlˈveɪniə/ (listen) PEN-sil-VAY-nee-ə), officially the Commonwealth of Pennsylvania, is a state located in the northeastern and Mid-Atlantic regions of the United States. The Appalachian Mountains run through its middle. The Commonwealth is bordered by Delaware to the southeast, Maryland to the south, West Virginia to the southwest, Ohio to the west, Lake Erie and the Canadian province of Ontario to the northwest, New York to the north, and New Jersey to the east.
Pennsylvania is the 33rd-largest state by area, and the 6th-most populous state according to the most recent of...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$45,161 to $54,879
Most Popular Cities in Pennsylvania for Reimbursement Specialist - Healthcare Jobs
What does a Reimbursement Specialist - Healthcare do?
Reimbursement Specialist - Healthcare in Dayton, OH
Accurate and efficient reimbursement adds value to all health care providers; and certified professional coders can help deliver that.
January 04, 2020
Reimbursement Specialist - Healthcare in Ventura, CA
Specialised mental healthcare includes diagnosis and specialist treatment of (highly) complex psychological disorders such as psychiatrists and clinical psychologists generally provide.
February 07, 2020
Reimbursement Specialist - Healthcare in Florence, AL
Through MedCert’s 22-week program, you will find yourself equipped to serve as a Reimbursement and EHR Health Specialist as well as prepared to gain certification as a Certified Electronic Health Records Specialist (CEHRS) and a Certified Billing and Coding Specialist (CBCS) providing needed support to healthcare providers.
December 15, 2019