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)
Billing & Reimbursement Specialist IITUMG Business Services Revenue Cycle
Location: New Orleans, LA
SummaryIn accordance with the accepted standards and practices of physician billing entities, to represent the physicians of the Tulane University Medical Group in the realization of all appropriate reimbursement for medical services rendered to patients.
Support the billing and collection activities under the direction of the Supervisor, Manager and/or Director.
Work in association with all areas of the Tulane University Medical Group Business Services, partners, Tulane University Hospital and Clinic Staff, and other internal and external persons.
Responsible for initial billing, claim follow up, resolution of rejected claims, claim edits resolution, handling of special accounts and keeping management informed of trends, updates and unusual or urgent issues.
Promotes an environment of high productivity and job satisfaction; perform in a leadership role, provide assistance to team members when necessary.
About the Company:
Tulane University
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