Reimbursement Specialist II

DepartmentRevenue Cycle Job Summary Provides administrative support responsible for accurate and timely posting of Surgery, Emergency Room (ECC) charges for either SMHCS or North Port, hospital wide observation charges, or Delivery/High Risk Antepartum/Testing/Triage charges, under the direction and supervision of Revenue Cycle Management. Provides compliant charging practices for all payors by reviewing the medical record for appropriate clinical documentation that supports the accuracy of charges. Independently resolves Surgery, Emergency Room, Observation, or Delivery/ High Risk Antepartum/Testing/Triage charge Correct Coding Initiative (CCI) edits. Performs other reimbursement assignments to resolve billing, coding, or collection issues. Interacts with clinical staff to educate and improve clinical documentation that supports the accuracy of care provided and charges posted. Assists Revenue Cycle staff in providing information to support appeals or audits. Acts as a leader, mentor, and trainer to other Reimbursement Specialists. Required Qualifications - Require a minimum of four (4) years of health care experience involving charging practices and patient flow processes.- Require coding certification. Preferred Qualifications - Prefer clinical certification from a recognized health care credentialing organization in a specialty area (i.e. RRA, RT, VI, CI, RCIS, RVS, SCFA and CST).- Prefer demonstrated interpersonal and communication skills.- Prefer working knowledge of commonly used computer applications.- Prefer the ability to work with minimal supervision.- Prefer demonstrated proficiency with medical terminology.- Prefer demonstrated proficiency with specific charging and coding as it applies to various departments (i.e. Surgery, Emergency Room, Observation, or Delivery/High Risk Antepartum/Testing/Triage). Mandatory Education HS EQ: High School Diploma, GED or Certificate Preferred Education Required License and Certs Preferred License and Certs         
One of the largest public health systems in Florida, Sarasota Memorial Health Care System has continually evolved from its modest beginning as the county's first community hospital. Our mission to deliver high-quality healthcare for our community has been steadfast since we first began serving patients in 1925 at the 32-bed Sarasota Hospital, and our growth has been shaped by and for the Sarasota community.

Today, we are a full-service public health system, with two hospitals offering specialized expertise in heart, vascular, cancer, orthopedic and neuroscience services, as well as a state-of-the-art cancer care center and a network of outpatient centers, urgent care centers, laboratories, diagnostic imaging and physician practices, skilled nursing and rehabilitation among our many programs. Sarasota Memorial also serves as the region's health care safety net, with Sarasota County's only trauma center, obstetrical services, neonatal intensive care unit, inpatient pediatrics unit and psychiatric services for patients of all ages.
The system's flagship 897-bed campus, Sarasota Memorial Hospital-Sarasota, has been consistently recognized as one of the nation’s best hospitals. A regional referral center providing the greatest depth and breadth of care to the community, the campus also includes state-of-the-art specialized centers of care, including the Brian D. Jellison Cancer Institute Oncology Tower, Rehabilitation Pavilion and newly opened Cornell Behavioral Health Pavilion.

With the opening of Sarasota Memorial Hospital-Venice in fall 2021, we're able to provide south Sarasota County residents convenient access to the same level of care and 5-Star physicians, staff and systems available at our SMH-Sarasota Campus. SMH-Venice features 178 private rooms, a 28-room Emergency Care Center, 8 surgical suites, 10 birthing suites and a pandemic-ready intensive care unit. The Venice campus is currently undergoing an expansion that will double the hospital's capacity when complete in 2024. 
Sarasota Memorial is powered by more than 10,000 staff and is Sarasota County’s largest employer. Over 700 members of the community contribute their time and skills as hospital volunteers; this includes the 9-member Sarasota County Public Hospital Board elected by local voters, governs Sarasota Memorial Health Care System.
Our Mission
Sarasota Memorial strives to provide healthcare services that excel in caring, quality and innovation.
Our Vision
Our community will be served by the best healthcare system in the nation. Sarasota Memorial will be the best place to be a patient, the best place to work and the best place to practice medicine. Our extraordinary people, innovative clinical technology and effective use of information systems will set us apart. We will deliver services that are safe, result in desired outcomes and are consistent with current professional knowledge.
Our Values
To create an environment that supports and rewards:

Safety
Caring and compassion
Excellence and professionalism
Teamwork and trust
Mutual respect and recognition
Accountable and ethical behavior