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)
Description
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
Summary:
Responsible for coordination of the entire patient admission experience.
Responsibilities:
1. Coordinates the entire admission process from inquiry through admittance. Ensures a quality transition for residents and families.
2. Ensures the proper case mix within budgetary guidelines. Works with managed care/insurance companies to establish payment rates prior to admission.
3. Maintains consistent contact with referring case managers and social workers for follow up information and problem solving, as needed.
4. Counsels patients and families regarding financial, social and placement concerns.
5. Supplies information and markets services of RCCC to the community and referral sources.
6. Facilitates the quality of resident's life through management of environmental factors and roommate preferences.
7. Assesses and screens all referrals for admission based on RCCC admission criteria. Coordinates and communicates admissions with clinical services at RCCC.
Legal Employer: NCHEALTH
Entity: UNC Rockingham Health Care
Organization Unit: MNC Social Services
Work Type: Full Time
Standard Hours Per Week: 40.00
Salary Range: $22.45 - $28.06 per hour (Minimum to Midpoint)
Pay offers are determined by experience and internal equity
Work Assignment Type: Onsite
Work Schedule: Day Job
Location of Job: US:NC:Eden
Exempt From Overtime: Exempt: No
This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Heath Care System. This is not a State employed position.
Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email applicant.accommodations@unchealth.unc.edu if you need a reasonable accommodation to search and/or to apply for a career opportunity.
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