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)
As a home health nurse (RN HH), you will deliver healthcare in patients' residences, helping them maintain their independence. You will provide one-on-one care for patients in their homes. These patients can be elderly, critically ill, or disabled or they may be recovering from a surgery, injury, or accident. A hospice nurse cares for terminally ill patients. Whether home health or hospice, you will assess patients' conditions and determine an individualized care plan. This will also include charting observations, administering medication and dressing wounds, educating patients and their families about care, and coordinating with other medical professionals involved in patients' care plans.
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