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)
Reimbursement Specialist
Physicians Services is seeking a Reimbursement Specialist to compile, process and maintain accounts receivable and patient revenue records and reports.
The Reimbursement Specialist is responsible for answering inquiries from patients and insurance sources regarding patient status as well as contacting insurance companies and using payer websites to secure outstanding payments. The Reimbursement Specialist also reviews rejections in assigned payers and plans to determine the validity of the rejection and takes action to resolve the claim.
Applicants must have an Associate’s Degree with three years previous billing, bookkeeping or accounting experience. The successful applicant will demonstrate experience in general healthcare accounting practices and proficiency with accounting software and EClinical Works EMR system.
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