Reimbursement Specialist - Healthcare jobs in Knoxville, TN

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)

C
Regional Director of Clinical Reimbursement
  • ClearView Healthcare Management
  • Knoxville, TN FULL_TIME
  • ClearView Healthcare Management is seeking a Regional Director of Clinical Reimbursement!

    Eastern and Central Tennessee area!

    As the Regional Director of Clinical Reimbursement, you will be a subject matter expert on Medicare/Medicaid reimbursement and regulatory issues and provide managerial support to our TN skilled nursing facilities by performing the following responsibilities:

    • Lead Projects (Medicare/Medicaid/MDS 3.0, EMR, etc.)
    • Research complex reimbursement and regulatory issues and provide analyses/summaries.
    • Provide education to other regional personnel and facility personnel on Medicare/Medicaid/MDS/Restorative/EMR regulatory issues.
    • Prepare and deliver formal technical presentations as needed to internal and external groups.
    • Analyze and report the impact of federal and state Medicare/Medicaid regulatory changes and develop responses if needed.
    • Responsible for partnering with clinical and financial team members to develop and enhance clinical reimbursement tools and systems.
    • Ensure that reimbursement structures are managed, evaluated and capture accurate resource utilization at the facility level.

    Qualifications:

    • Licensed Registered Nurse in State of TN.
    • At least 3 years of MDS experience in long term care preferred.
    • Extensive experience in Medicare, PPS and TN state reimbursement systems.
    • Knowledge of the Resident Assessment Instrument (RAI) needed.
    • Strong knowledge of case mix, therapy utilization and restorative nursing.
    • Experience in adult training and education.
    • Minimal travel but occasional overnights may be expected.

    Benefits: Health, dental, vision and life insurance

    EQUAL OPPORTUNITY EMPLOYER

    The Facility is an equal opportunity employer. The Facility does not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. The Facility will also make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Facility including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.

     

     

     

     

  • 23 Days Ago

H
Reimbursement Specialist – Knox
  • Helen Ross McNabb Center
  • Knoxville, TN FULL_TIME
  • Do you want to help ensure the continued success of an organization known for its positive impact in our community? Do you have a passion for detail oriented work and ensuring accuracy in data entry? ...
  • 1 Day Ago

S
Field Reimbursement Specialist
  • Syneos Health Clinical
  • Knoxville, TN FULL_TIME
  • Description You are an expert facilitator: you open doors, foster communication, and bridge the gap. In this role, you will be responsible for the management of defined accounts in a specified geograp...
  • 1 Month Ago

T
Lawn Specialist
  • TruGreen - Lawn Specialist - Alcoa, TN
  • Fontana Dam, NC FULL_TIME
  • TruGreen is Hiring Residential Lawn Specialists Immediate Openings in Alcoa, TN At TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A career with TruGr...
  • 2 Days Ago

T
Specialist, Medical Office
  • TruGreen - Lawn Specialist - Alcoa, TN
  • Fontana Dam, NC FULL_TIME
  • Immediate Openings in Alcoa, TN At TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. 00 per hour Average income is $850 - $1,200 per week* - Based on ho...
  • 1 Day Ago

A
Retail Merchandiser (PT)
  • Apollo Retail Specialist
  • Knoxville, TN PART_TIME
  • As a merchandiser, you’ll take on project-based work to ensure products and displays are visually appealing to attract and engage shoppers, build strong relationships with store managers, ensure the r...
  • 23 Days Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Reimbursement Specialist - Healthcare jobs found in Knoxville, TN area

O
Nurse Practitioner - Advanced Practice Provider
  • Oak Street Health Inc.
  • Knoxville, TN
  • Title: Nurse Practitioner - Advanced Practice Provider Schedule: Full-Time, Monday through Friday, 8:00 AM - 5:00 PM Loc...
  • 3/28/2024 12:00:00 AM

S
Shredding Specialist
  • Stericycle Inc.
  • Knoxville, TN
  • Title: Shredding Specialist Requisition Id: 32750 Job Function: Plant/Processing Operations Career Area: Operations Work...
  • 3/28/2024 12:00:00 AM

A
Insurance Agency Owner
  • AAA-The Auto Club Group
  • Knoxville, TN
  • AAA - The Auto Club Group, is seeking ambitious, business-minded, and visionary Entrepreneurial Agency Owners to join ou...
  • 3/27/2024 12:00:00 AM

E
Intake Specialist
  • Elder Law of East Tennessee, PLLC
  • Knoxville, TN
  • Job Description Job Description About the Firm: Elder Law of East Tennessee is a law firm that specializes in Life Care ...
  • 3/27/2024 12:00:00 AM

S
Claims Research Specialist
  • SOUTHEASTERN RETINA ASSOCIATES PC
  • Knoxville, TN
  • Job Description Job Description Assist with the revenue cycle management of SERA’s Billing Department with a primary foc...
  • 3/26/2024 12:00:00 AM

O
Consumer Loan Sales Specialist
  • OneMain Financial
  • Knoxville, TN
  • At OneMain, Consumer Loan Sales Specialists empower customers listening to their needs and providing access to friendly,...
  • 3/25/2024 12:00:00 AM

B
FP&A Supervisor
  • BHS Corrugated North America
  • Knoxville, TN
  • BHS Corrugated is seeking an FP&A Supervisor to join our growing team in our Knoxville, TN facility! Summary The FP&A Su...
  • 3/25/2024 12:00:00 AM

S
Merchandising & Product Demonstration Specialist
  • SAS Retail Services
  • Knoxville, TN
  • Join our dynamic team as a Merchandising & Product Demonstration Specialist! In this multifaceted role, you'll excel in ...
  • 10/13/2023 12:00:00 AM

Knoxville is a city in the U.S. state of Tennessee, and the county seat of Knox County. The city had an estimated population of 186,239 in 2016 and a population of 178,874 as of the 2010 census, making it the state's third largest city after Nashville and Memphis. Knoxville is the principal city of the Knoxville Metropolitan Statistical Area, which, in 2016, was 868,546, up 0.9 percent, or 7,377 people, from to 2015. The KMSA is, in turn, the central component of the Knoxville-Sevierville-La Follette Combined Statistical Area, which, in 2013, had a population of 1,096,961. First settled in 178...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$41,567 to $50,509
Knoxville, Tennessee area prices
were up 1.3% from a year ago

Reimbursement Specialist - Healthcare in Anchorage, AK
Bureau of Labor Statistics, occupations and industries related to healthcare are projected to add more new jobs to the U.S.
December 07, 2019
Reimbursement Specialist - Healthcare in Brownsville, TX
You will also be notified when something of note is happening around the Coding and Reimbursement Specialist program.
January 26, 2020
Reimbursement Specialist - Healthcare in Charlotte, NC
MedCert’s Reimbursement and EHR Specialist Certification program is well rounded and features 24/7 access to the curriculum with video and course content, program supplements, and all the resources your need for successful independent study.
January 08, 2020