| Reimbursement Specialist - Healthcare Job Description |
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| The following is a full job description for Reimbursement Specialist - Healthcare. Here are the requirements and responsibilities for Reimbursement Specialist - Healthcare along with statistics. If after reading this page you determine that Reimbursement Specialist - Healthcare is not the position you are looking for, you may want to try one of these similar titles: Reimbursement Specialist - Healthcare, Reimbursement Services Director, Payment Recovery Specialist, Market Access Specialist IV, Risk Management Analyst I - Healthcare, Healthcare EDI Analyst, Collections Specialist - Healthcare, Reimbursement Services Director - Home Care, Quality Assurance Coordinator - Healthcare, Quality Assurance Manager - Healthcare |
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| Requirements and Responsibilities For 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. 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. May require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. Gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. Typically requires 2 to 4 years of related experience. |
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| Also referred to as: Provider Reimbursement Validation Specialist, Reimbursement Coding Verification Specialist |
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| Similar Jobs: Reimbursement Specialist - Healthcare, Reimbursement Services Director, Payment Recovery Specialist, Market Access Specialist IV, Risk Management Analyst I - Healthcare, Healthcare EDI Analyst, Collections Specialist - Healthcare, Reimbursement Services Director - Home Care, Quality Assurance Coordinator - Healthcare, Quality Assurance Manager - Healthcare |
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| Level of Education: Reimbursement Specialist - Healthcare Salaries with an Associate's Degree, Reimbursement Specialist - Healthcare Salaries with a Bachelor's Degree, Reimbursement Specialist - Healthcare Salaries with a Master's Degree or MBA, Reimbursement Specialist - Healthcare Salaries with a JD, MD, PhD or Equivalent |
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| Industries: Edu., Gov't. & Nonprofit, Healthcare | |
