Reimbursement Specialist - Healthcare jobs in Ohio

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
  • Management & Network Services
  • Dublin, OH FULL_TIME
  • Position Summary: Reconciliation of skilled nursing facility patient accounts, billing, collections, cash posting, refund requests, and payor relations.

    Essential Functions

    • Process overpayment and refund requests from payors
    • Patient account reconciliation, including researching payor portals for claim status and following up with payors for reimbursement
    • Assist team in meeting outstanding claims goals set forth by Reimbursement Manager
    • Follow through on payor requests as they relate to A/R collection
    • Post all cash, co-pays, deductibles, co-insurance, and interest payments for assigned payor.
    • Assist with month end A/R balancing and closing
    • Receive, enter, and release billing information from clean nursing facility inpatient and outpatient claims into billing software in preparation for electronic submission
    • Print and mail clean hard copy claims to appropriate contracted payers
    • Review and bill all claims in re-bill status
    • Communicate professionally and timely with internal and external customers; Support co-workers and engage in positive interactions.
    • Participate in quality improvement process
    • Responsible for meeting all key performance indicators as outlined in departmental goals
    • Assist co-workers in completion of critical tasks during times of peak case loads
    • Participate as an active team member within the Reimbursement department and with all MNS departments
    • Attend company provided training classes as required
    • Attend departmental meetings and company meetings as requested
    • Applies critical thinking and uses sound judgment effectively to perform job tasks.
    • Work on special projects as needed
    • Protect and safeguard all patient, facility, and insurance information confidentiality
    • Maintains client confidentiality of protected information during employment and post-employment.
    • Demonstrates reliable and predictable attendance and punctuality; does not negatively impact the customer, department, or co-workers.
    • Reads and adheres to all policies and manuals including but not limited to billing, collections, A/R, and general business operations.
    • Performs any other reasonable duties as required

    Authority, Report Preparation

    • Delegated authority, responsibility, and accountability necessary to carry out assigned reimbursement department tasks and workflow
    • Ability to prioritize workflow
    • Work with little supervision
    • Evaluation will be completed by the Reimbursement Manager
    • Reports to the Reimbursement Manager

    Specifications: Mental/Physical/Appearance

    • Able to move intermittently for extended periods throughout the workday
    • Able to cope with the related stress of the position
    • Able to read, write and speak the English language in an understandable manner
    • Able to function independently
    • Able to lift, push, pull and move a minimum of 20 lbs
    • Develop and maintain a good working rapport with interdepartmental personnel, as well as other departments within MNS
    • Deal tactfully with personnel, peers and management
    • Create and maintain a professional atmosphere and a positive attitude, as well as a calm environment
    • Appropriately dressed for the position; this includes internal and external functions

    Experience, Education, Training as Required

    • Must possess at minimum a high school diploma or equivalent
    • Minimum 2-years office experience
    • Medical office and/or medical billing and insurance follow-up experience preferred
    • Prior experience with skill nursing facility Medicaid billing desirable
    • Ability to organize and prioritize a high-volume workload
    • Excellent verbal and written skills
    • Demonstrated ability to resolve customer issues through research, analysis, and action
    • Knowledge of insurance payments, including understanding Explanation of Benefits, medical terminology, copays, deductibles, and patient liability
    • Working knowledge of email and telephone etiquette
    • Able to follow written and oral instructions
    • Able to type proficiently and effective use of a ten-key calculator
    • Proficient with Microsoft Excel and Word
    • Excellent customer service

    Job Type: Full-time

    Benefits:

    • 401(k)
    • 401(k) matching
    • Dental insurance
    • Flexible schedule
    • Flexible spending account
    • Health insurance
    • Health savings account
    • Life insurance
    • Paid time off
    • Tuition reimbursement
    • Vision insurance

    Schedule:

    • 8 hour shift
    • Day shift
    • Monday to Friday

    Work setting:

    • Hybrid work
    • Office

    Experience:

    • Medical collection: 1 year (Preferred)
    • Office: 1 year (Required)

    License/Certification:

    • Medical Billing Certification (Preferred)

    Work Location: Hybrid remote in Dublin, OH 43016

  • 1 Month Ago

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Healthcare Reimbursement - Consulting Sr. Manager
  • Plante Moran
  • Columbus, OH FULL_TIME
  • Location: United States, Ohio, ColumbusLocation: United States, Ohio, Cleveland Make your mark. Our senior care healthcare consulting team focuses on our clients' critical business needs. Our team wor...
  • 16 Days Ago

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Vice President of Reimbursement and Operational Finance, Healthcare
  • CommuniCare Family of Companies
  • Cincinnati, OH FULL_TIME
  • Vice President, Reimbursement and Operational Finance CommuniCare Health Services is a fast-growing provider of long-term care with over 130 facilities located in 7 states. Due to current growth, we a...
  • 9 Days Ago

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RN MDS (Reimbursement Specialist)
  • Progressive Quality Care
  • Parma, OH FULL_TIME
  • Parma Care Center has provided a family-like atmosphere for over three decades, with staff members who work as a team. Parma Care Center provides excellent care to our residents along with ancillary s...
  • 19 Days Ago

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Reimbursement Specialist II
  • Alternate Solutions Health Network
  • Dayton, OH FULL_TIME
  • Agency: Alternate Solutions Health Network Our culture and people are what set us apart from other post-acute care providers. We're dedicated to the growth and development of our team to set them up f...
  • 21 Days Ago

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Field Reimbursement Specialist
  • Syneos Health Commercial Solutions
  • Cleveland, OH 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...
  • 24 Days Ago

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Clinical Reimbursement Specialist
  • Life Care Centers of America
  • Altamonte Springs, FL
  • Position Summary The Clinical Reimbursement Specialist ensures correct monetary reimbursement for any services offered t...
  • 3/28/2024 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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Medical Reimbursement Specialist
  • HealthDrive Corporation
  • Framingham, MA
  • Answer incoming facility and billing related customer telephone calls and provide exceptional customer service when inte...
  • 3/24/2024 12:00:00 AM

Ohio /oʊˈhaɪoʊ/ (listen) is a Midwestern state in the Great Lakes region of the United States. Of the fifty states, it is the 34th largest by area, the seventh most populous, and the tenth most densely populated. The state's capital and largest city is Columbus. The state takes its name from the Ohio River, whose name in turn originated from the Seneca word ohiːyo', meaning "good river", "great river" or "large creek". Partitioned from the Northwest Territory, Ohio was the 17th state admitted to the Union on March 1, 1803, and the first under the Northwest Ordinance. Ohio is historically know...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$44,434 to $53,992

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