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)
HEALTHCARE QUALITY ASSURANCE SPECIALIST
FULL TIME-flexible schedule between 6am-6pm
HYBRID-North Fort Myers/Remote
Millennium Physician Group is seeking to hire a full-time Healthcare Quality Assurance Specialist to join our team. We are looking for a new team member who is positive, energetic, well-organized, innovative, and organized. We want someone who supports our top initiative of ensuring an excellent patient experience!
The Quality Assurance Specialist is responsible to assist the department in ongoing HEDIS collection and Quality Improvement Activities. The position reports to Quality Assurance management. This position includes ongoing quality improvement activities to assure the organization's quality programs are implemented and meet all requirements for successful HEDIS and quality metric reporting to contracted carriers.
Minimum three years experience in a medical office and current CMA/RMA license.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Benefits:
See Full Job Description for more details
Why Millennium?
Millennium Physician Group is one of the largest comprehensive primary care practices with healthcare providers throughout Florida.
At Millennium Physician Group, you will find an organization that focuses on family and building a strong network of people to care for the communities we serve. We are always searching for employees who have a strong customer service attitude, fantastic teamwork skills and a willing smile ready to share.
Our promise is to provide you with the tools to do your job successfully, as well as providing a team atmosphere that empowers you to seek better ways to deliver care to our patients and their families. We also promise to care for you as an individual, and help you grow in your role with Millennium Physician Group.
If you are interested in joining an organization that puts an emphasis on team work and family, then Millennium Physician Group is the right choice
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