Reimbursement Specialist - Healthcare jobs in District of Columbia

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)

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Reimbursement Specialist
  • Office of the Chief Financial Officer (OCFO)
  • Washington, DC FULL_TIME
  • SERVICING  PERSONNEL OFFICE/UNIT: Office of Human  Resources
    POSITION SERIES: DS - 501
    POSITION GRADE: DS-12
    IF "OPEN UNTIL FILLED," FIRST SCREENING DATE: October 27, 2023
    TOUR OF DUTY: To Be Determined
    AREA OF CONSIDERATION: Unlimited
    PROMOTION POTENTIAL: None
    NO. OF VACANCIES: One (1) or more
    AGENCY: Human Support Service Cluster (HSSC), Department of Health Care Finance (DHCF)
    DURATION OF APPOINTMENT : Permanent
    COLLECTIVE BARGAINING UNIT: This position is not in a collective bargaining unit.
     
    BRIEF DESCRIPTION OF DUTIES:  This position is located within the Office of the Chief Financial Officer (OCFO), Human Support Services Cluster (HSSC), Department of Health Care Finance (DHCF). The Reimbursement Specialist coordinates, monitors, and performs various functions related to, the analysis, identification, interpretation, reporting and resolution of provider reimbursement information and claims. Duties include, but are not limited to: monitoring cost reports and supporting documentation; researching, reviewing, and providing interpretation on federal and local rules and Medicaid policies; reviewing submitted audited cost reports and providing information to audit contractors on policies and procedures; searching for variances from prior periods and looking for trends in cost reporting data; reviewing audited cost reports and responding to questions regarding cost reports; providing documentation, explanations, and testifying as a government witness to assist DHCF legal staff with appeals before the Office of Administrative Hearings and the District courts; communicating and responding to questions regarding healthcare provider taxes; and providing schedules, analysis, work papers, and explanations for the Medicaid Year End Accrual. Performs other duties as assigned.Four (4) years of progressive experience performing the related duties and responsibilities such as reviewing, analyzing, auditing cost reports and financial statements; developing comprehensive oral and written reports; and assisting in the preparation and delivery of oral briefings and testimony. Healthcare industry experience preferred.Experience that provides the applicant with the particular knowledge, skills, and abilities to perform successfully the duties of the position, and that is typically in or related to the work of the position to be filled. To be creditable, specialized experience must have been equivalent to at least the next lower grade level in the normal line of progression for this position.
     

    COVID-19 VACCINATION: 

     

    The Office of the Chief Financial Officer values the safety of our employees, our residents, and our visitors. In support of these values, OCFO employees are strongly encouraged to be immunized against COVID-19. 

     
    COLLECTIVE BARGAINING UNIT:
     
    Employment with the OCFO is at will.  However, the discipline and/or discharge of bargaining unit employees is governed by the collective bargaining agreement.
     
    EEO STATEMENT: 
     
    The OCFO is an Equal Opportunity Employer. All qualified candidates will receive consideration without regard to race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, family responsibilities, matriculation, physical handicap, or political affiliation.
     
    HOW TO APPLY: 

    All Applicants, including departmental employees and other DC Government Employees, must submit an OCFO employment application at cfo.dc.gov. (Resume may be attached). Incomplete applications will not be considered.  Employees affected by restructuring must submit their application with the application transmittal form. All applications, transcripts, and supporting documents must be received by close of business (5:00 PM) on the closing date of the announcement or they will not be considered.

    NOTE:  It is imperative that all information on the employment application, resume and supporting documents be both accurate and truthful and is subject to verification.  Misrepresentations of any kind may be grounds for disqualification for this position or termination.
     
    JOB OFFERS:
     
    Official job offers are made only by the OCFO’s Office of Human Resources. 
     
    PHYSICAL EFFORT:
     
    Sedentary 
     
    REASONABLE ACCOMMODATION REQUESTS:
     
    If you are scheduled for an interview and require any reasonable accommodation in our interview process, please inform the hiring representative who contact you to schedule your interview.  Whenever possible, please give the hiring representative sufficient time to consider and respond to your request.  
     
    RESIDENCY PREFERENCE:  
     
    An external applicant for a position in the OCFO who is a bona fide resident of the District of Columbia at the time of application, may claim a hiring preference over a non-resident applicant by completing the 'Residency Preference for Employment' form, DC 2000RP, and uploading and attaching it to their employment application. To be granted preference, an applicant must: (1) be qualified for the position; and (2) submit a claim form at the time of application. Except for employees entitled by law to preference, preference will not be granted unless the claim is made at the time of application. This preference is only granted upon initial appointment.
     
    NOTICE OF NON-DISCRIMINATION:  
     
    In accordance with the D.C. Human Rights Act of 1977, as amended, D.C. Official Code section 2-1401.01 et seq., (Act) the District of Columbia does not discriminate on the basis of actual or perceived: race, color, religion, national origin, sex, age, marital status, personal appearance, sexual orientation, familial status, family responsibilities, matriculation, political affiliation, disability, source of income, or place of residence or business. Sexual harassment is a form of sex discrimination, which is also prohibited by the Act. In addition, harassment based on any of the above, protected categories is prohibited by the Act. Discrimination in violation of the Act will not be tolerated. Violators will be subject to disciplinary action. 
     
    NOTICE OF BACKGROUND INVESTIGATION AND PENALTIES FOR FALSE STATEMENTS:
     
    Employment with the OCFO is subject to the completion and satisfactory result of a background investigation conducted by the OCFO.  For most positions, the investigation is conducted after commencement of duty, at which time you will be provided background and release of information forms to complete.  For more information, see the Employment Opportunities section at the OCFO website (www.cfo.dc.gov).  Certain highly sensitive positions however warrant completion of the OCFO background investigation prior to commencement of duty.  You will be informed if this is required.
     
    Applicant understands that a false statement on any part of your application, including materials submitted with the application, may be grounds for not hiring you, or for firing you after you begin work (D.C. Official Code, section 1-616.51 et seq.) (2001).  The applicant understands that making a false statement on the application or on materials submitted with the application is punishable by criminal penalties pursuant to D.C. Official Code, section 22-2405 et seq. (2001).
     
    SALARY REDUCTION OF REEMPLOYED ANNUITANTS: 
     
    An individual selected for employment in the District Government on or after January 1, 1980, who is receiving an annuity under any District government civilian retirement system, shall have his or her pay reduced by the amount of annuity allocable to the period of employment as a reemployed annuitant.
     
    VETERANS PREFERENCE: 
     
    Applicants claiming veteran’s preference must submit official proof with the application.

    WORKING CONDITION:

    Office Environment

  • Just Posted

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Communications Specialist (Associate) - Healthcare
  • DCG Communications
  • Washington, DC FULL_TIME
  • DCG Communications (DCG) is seeking a motivated Communications Specialist (Associate) to join our anticipated client team that will provide project management and communications activities on behalf o...
  • 2 Months Ago

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Field Reimbursement Manager
  • Syneos Health/ inVentiv Health Commercial LLC
  • Washington, DC FULL_TIME
  • Description You are an expert facilitator: you open doors, foster communication, and bridge the gap. The Field Reimbursement Manager will be responsible for the management of defined accounts in Urolo...
  • 6 Days Ago

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Healthcare Staffing Coordinator
  • BridgePoint Healthcare
  • Washington, DC OTHER
  • Job Details Job Location: National Harbor SNF - Washington, DC Position Type: Full Time Education Level: High School Salary Range: Undisclosed Job Shift: Day Job Category: Ancillary / Other Descriptio...
  • 23 Days Ago

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Outreach and Community Engagement Specialist
  • PRESTIGE HEALTHCARE RESOURCES INC
  • Washington, DC FULL_TIME
  • The Outreach and Community Engagement Specialist provides a vital link in connecting Prestige Healthcare Resources, Inc. (PHRI) with the community, engaging consumers, and raising awareness about ment...
  • 22 Days Ago

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Peer Recovery Specialist (FT)
  • Prestige Healthcare Resources
  • Washington, DC FULL_TIME
  • Under the direct supervision of the SUD Clinical Manager, the Certified Peer Recovery Specialist role serves to support others in recovery from a substance use disorder (SUD, OUD, and alcohol use). Th...
  • 1 Day Ago

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Clinical Reimbursement Specialist - RN
  • Vi Living
  • Palo Alto, CA
  • Overview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from th...
  • 3/27/2024 12:00:00 AM

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Clinical Reimbursement Specialist
  • Southeast Division
  • Altamonte Springs, FL
  • Position Summary The Clinical Reimbursement Specialist ensures correct monetary reimbursement for any services offered t...
  • 3/27/2024 12:00:00 AM

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Clinical Reimbursement Specialist
  • Southwest Division
  • Las Vegas, NV
  • Position Summary The Clinical Reimbursement Specialist ensures correct monetary reimbursement for any services offered t...
  • 3/27/2024 12:00:00 AM

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Clinical Reimbursement Specialist
  • CareOne
  • Fort Lee, NJ
  • Now Hiring - Clinical Reimbursement Specialist - Fort Lee, NJ 07024 The Clinical Reimbursement Specialist assures the im...
  • 3/26/2024 12:00:00 AM

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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...
  • 3/25/2024 12:00:00 AM

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Reimbursement Specialist
  • By The Bay Health
  • Larkspur, CA
  • This position offers competitive pay, generous benefits, and a supportive work environment! We are seeking a full-time R...
  • 3/25/2024 12:00:00 AM

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Reimbursement Specialist
  • PROMPTCARE HOME INFUSION LLC
  • New Providence, NJ
  • Job Type Full-time Description PromptCare is seeking a highly motivated and detail-oriented Reimbursement Specialist to ...
  • 3/25/2024 12:00:00 AM

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Clinical Reimbursement Specialist - LVN
  • Vi Living
  • Palo Alto, CA
  • Overview: Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from th...
  • 3/19/2024 12:00:00 AM

Washington, D.C. is located in the mid-Atlantic region of the U.S. East Coast. Due to the District of Columbia retrocession, the city has a total area of 68.34 square miles (177.0 km2), of which 61.05 square miles (158.1 km2) is land and 7.29 square miles (18.9 km2) (10.67%) is water. The District is bordered by Montgomery County, Maryland to the northwest; Prince George's County, Maryland to the east; Arlington County, Virginia to the south; and Alexandria, Virginia to the west. The south bank of the Potomac River forms the District's border with Virginia and has two major tributaries: the An...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$50,434 to $61,282

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