Reimbursement Specialist - Healthcare jobs in Temecula, CA

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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Corporate Senior Government Reimbursement Specialist
  • Prime Healthcare Management Inc
  • Ontario, CA FULL_TIME
  • Overview

    Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nation’s leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit public charity. Prime Healthcare is actively seeking new members to join our corporate team!

    Responsibilities

    Involved in preparation of various government reports and support their audits. The Corporate Senior Government Reimbursement Specialist is responsible for preparing and understanding the complexity of a cost report. The Corporate Senior Government Reimbursement Specialist fully understands how one section of the report is linked to another and be able to evaluate the accuracy of the entire report.

     

    Qualifications

    Required qualifications:

  • Bachelor’s degree Accounting or Finance
  • Minimum 15 years in Government reimbursement and cost report preparation experience in a multi-hospital system.
  • Experience in preparing and completing entire Medicare and Medicaid cost reports for a multi-state hospital system and provide the support at audit
  • Knowledge of Medicare rules on Medicare DSH, Medicare bad debts, charity and hospital bad debts for S-10, Interns and Residents FTE counts, ESRD Add-on, Nurse Allied Health Education, Rural Health Clinic, Sole Community Hospital, Critical Access Hospital and Low Volume Adjustment.  Apply the knowledge when preparing the cost report and its subsequent audit.
  • Experience working with Besler’s EZWP program, HFS, PS&R, 835 files, financial statement and patient account data.
  •  

    Preferred qualifications:

  • Strong analytical skills and resourceful
  • Experience working with hospital GL and patient accounting systems (Lawson, EPIC, Meditech)
  • Strong communication skills
  •  

    We are an Equal Opportunity/Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics.  If you need special accommodation for the application process, please contact Human Resources.  EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf

    Prime Healthcare offers competitive compensation and a comprehensive benefits package that provides employees the flexibility to tailor benefits according to their individual needs. Our Total Rewards package includes, but is not limited to, paid time off, a 401K retirement plan, medical, dental, and vision coverage, tuition reimbursement, and many more voluntary benefit options.  Benefits may vary based on employment status, i.e. full-time, part-time, per diem or temporary.  A reasonable compensation estimate for this role, which includes estimated wages, benefits, and other forms of compensation, is $94,848.00 to $142,272.00 on an annualized basis. The exact starting compensation to be offered will be determined at the time of selecting an applicant for hire, in which a wide range of factors will be considered, including but not limited to, skillset, years of applicable experience, education, credentials and licensure.

  • 19 Days Ago

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Corporate Senior Government Reimbursement Specialist
  • Prime Healthcare Services
  • Ontario, CA FULL_TIME
  • Corporate Senior Government Reimbursement Specialist Facility Prime Healthcare Management Inc Location US-CA-Ontario ID 2024-150769 Category Business Professional Position Type Full Time Shift Days Jo...
  • 21 Days Ago

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Corporate Manager Government Reimbursement and Reporting
  • Prime Healthcare Management Inc
  • Ontario, CA FULL_TIME
  • Overview Prime Healthcare is an award-winning health system headquartered in Ontario, California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providi...
  • 12 Days Ago

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Corporate Manager Government Reimbursement and Reporting
  • Prime Healthcare Services
  • Ontario, CA FULL_TIME
  • Corporate Manager Government Reimbursement and Reporting Facility Prime Healthcare Management Inc Location US-CA-Ontario ID 2024-149217 Category Manager Position Type Full Time Shift Days Job Type Exe...
  • 14 Days Ago

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Healthcare QA specialist
  • United Parcel Service
  • MIRA LOMA, CA FULL_TIME
  • Before you apply to a job, select your language preference from the options available at the top right of this page.Explore your next opportunity at a Fortune Global 500 organization. Envision innovat...
  • 3 Days Ago

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Outside Sales Healthcare Specialist
  • Comcentric Inc.
  • Riverside, CA FULL_TIME
  • We are seeking Outside Sales Healthcare Specialist for a Full time Role in Riverside, CA. Location: Riverside, CA Pay Range: 57K – 70K per year commissions Benefits: Medical insurance coverage (Medica...
  • 26 Days Ago

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0 Reimbursement Specialist - Healthcare jobs found in Temecula, CA area

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Lake Elsinore, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • San Juan Capistrano, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Corona, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Trabuco Canyon, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • Mission Viejo, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • San Clemente, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • El Cajon, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

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Data Entry Specialist (Work From Home)>
  • CareMetx
  • La Mesa, CA
  • [Administrative Assistant / Fully Remote] - Anywhere in U.S. / Competitive Pay - As a Data Entry Specialist you'll: Main...
  • 4/18/2024 12:00:00 AM

Temecula /təˈmɛkjʊlə/ is a city in southwestern Riverside County, California, United States. The city is a tourist destination, with the Temecula Valley Wine Country, Old Town Temecula, the Temecula Valley Polo Club, the Temecula Valley Balloon & Wine Festival, the Temecula Valley International Film Festival, championship golf courses, and resort accommodations for tourists which contribute to the city's economic profile. The City of Temecula, forming the southwestern anchor of the Inland Empire region, is approximately 58 miles (93 km) north of downtown San Diego and 85 miles (137 km) southea...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$48,111 to $58,461
Temecula, California area prices
were up 3.0% from a year ago

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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