Current jobs related to Clinical Reimbursement Specialist - San Diego - Vi Living


  • San Diego, California, United States Vi Living Full time

    Job Title: Clinical Reimbursement SpecialistAt Vi Living, we are seeking a highly skilled Clinical Reimbursement Specialist to join our team. As a Clinical Reimbursement Specialist, you will play a critical role in ensuring accurate and timely reimbursement for services provided to our residents.Responsibilities:Collaborate with the DON, CRM, and other...


  • San Diego, United States Rady Children's Hospital Full time

    JOB SUMMARY: Under the direction of PFS Leadership, the Reimbursement Specialist I is responsible for billing and collections of outstanding account balances for commercial, government, and managed care payors as assigned. The Reimbursement Specialist I is required to identify and report payor issues to their leadership. It is a requirement for the...


  • San Diego, California, United States Rady Children's Hospital Full time

    Rady Children's Hospital is seeking a skilled Reimbursement Specialist I to join our team. The ideal candidate will have a strong background in billing and collections, with experience in managing commercial, government, and managed care payors. The Reimbursement Specialist I will be responsible for identifying and reporting payor issues, reading and...


  • San Diego, California, United States Rady Children's Hospital Full time

    Job Summary:Under the direction of PFS Leadership, the Reimbursement Specialist I is responsible for billing and collections of outstanding account balances for commercial, government, and managed care payors as assigned.The Reimbursement Specialist I is required to identify and report payor issues to their leadership.It is a requirement for the...


  • San Diego, California, United States Rady Children's Hospital Full time

    Rady Children's Hospital is seeking a skilled Reimbursement Specialist I to join our team. The ideal candidate will have a strong background in billing and collections, with experience in managing commercial, government, and managed care payors. The Reimbursement Specialist I will be responsible for identifying and reporting payor issues, reading and...


  • San Diego, California, United States ALLIANCE CLINICAL LLC Full time

    Job SummaryThe Clinical Phlebotomy Specialist will perform phlebotomy on research clinic patients using established laboratory procedures under the direction and ongoing supervision of the Clinical Operations Manager and the Principal Investigator.Key Responsibilities:Comply with all company policies, procedures, and conduct.Strictly adhere to...


  • San Diego, California, United States Rady Children's Hospital Full time

    Job Summary:Under the direction of PFS Leadership, the Reimbursement Specialist I is responsible for billing and collections of outstanding account balances for commercial, government, and managed care payors as assigned.The Reimbursement Specialist I is required to identify and report payor issues to their leadership.This position requires the ability to...


  • San Diego, California, United States Rady Children's Hospital Full time

    Job SummaryUnder the direction of PFS Leadership, the Reimbursement Specialist I is responsible for managing commercial, government, and managed care payor relationships to ensure timely and accurate reimbursement for outstanding account balances.The Reimbursement Specialist I must possess strong analytical and communication skills to identify and report...


  • San Diego, California, United States Rady Children's Hospital Full time

    Rady Children's Hospital is seeking a skilled Reimbursement Specialist I to join our team. The successful candidate will be responsible for managing commercial, government, and managed care payor accounts, ensuring timely and accurate reimbursement. Key responsibilities include: * Identifying and resolving payor issues through effective communication and...


  • San Diego, California, United States Rady Children's Hospital Full time

    Job Summary:The Reimbursement Specialist I is a key member of the Rady Children's Hospital team, responsible for ensuring timely and accurate reimbursement for commercial, government, and managed care payors. This role requires strong analytical and communication skills, as well as the ability to interpret complex payor contract language.Key...


  • San Diego, California, United States San Ysidro Health Center Full time

    Job SummaryThe Reimbursement Specialist II is a key member of our revenue cycle team, responsible for ensuring accurate and timely reimbursement for medical, dental, and hospital claims. This role requires strong analytical and communication skills, as well as the ability to work independently and as part of a team.Key ResponsibilitiesPrepare and review...


  • San Diego, California, United States San Ysidro Health Center Full time

    Job SummaryThe Reimbursement Specialist II is a key member of our revenue cycle team, responsible for ensuring accurate and timely reimbursement for medical, dental, and hospital claims. This role requires strong analytical and communication skills, as well as the ability to work independently and as part of a team.Key ResponsibilitiesPrepare and review...


  • San Diego, California, United States Rady Children's Hospital Full time

    Job Summary:Under the direction of Rady Children's Hospital Leadership, the Reimbursement Specialist I is responsible for managing the billing and collections process for commercial, government, and managed care payors. This role requires strong analytical and communication skills to identify and resolve payor issues, read and interpret complex payor...


  • San Diego, California, United States San Ysidro Health Center Full time

    Job SummaryThe Reimbursement Specialist II is a key member of our revenue cycle team, responsible for ensuring accurate and timely reimbursement for medical, dental, and hospital claims. This role requires strong analytical and communication skills, as well as the ability to work independently and as part of a team.Key ResponsibilitiesPrepare and review...


  • San Diego, California, United States San Ysidro Health Center Full time

    Job SummaryThe Reimbursement Specialist II is a key member of our revenue cycle team, responsible for ensuring accurate and timely reimbursement for medical, dental, and hospital claims. This role requires strong analytical and communication skills, as well as the ability to work independently and as part of a team.Key ResponsibilitiesPrepare and transmit...


  • San Jose, California, United States Vi Living Full time

    Job SummaryWe are seeking a skilled Clinical Reimbursement Coordinator - Registered Nurse to join our team at Vi Living. This role is responsible for collaborating with the Director of Nursing and various disciplines to ensure accurate and optimal reimbursement for services provided within our Care Center.Key Responsibilities:Assist in the completion of the...

  • MDS Coordinator

    2 days ago


    San Mateo, California, United States Vi Living Full time

    Job SummaryAs a skilled MDS Coordinator - Clinical Reimbursement Specialist at Vi Living, you will play a vital role in ensuring the accurate and timely completion of the Minimum Data Set (MDS) and Resident Assessment Instrument (RAI). Collaborating with the DON, CRM, and various disciplines, you will assist in managing the overall resident assessment...


  • San Diego, California, United States PROMETHEUS LABORATORIES INC Full time

    Job DescriptionPrometheus Laboratories Inc. is seeking a skilled Reimbursement and Contracts Specialist to support the Health Systems, Market Access, Payor Relations, and Legal teams. This role will involve managing contracts, facilitating communication between teams, and ensuring that contracts are processed and documented appropriately.Key...


  • San Diego, California, United States vTech Solution Full time

    Job Summary:As a Reimbursement Specialist at vTech Solution, you will be responsible for billing and collections of outstanding account balances for commercial, government, and managed care payors. This role requires strong analytical and communication skills to identify and report payor issues to leadership.The ideal candidate will have proficiency in...


  • San Diego, United States San Ysidro Health Center Full time

    Position Summary: The Reimbursement Specialist II is responsible for the complete revenue cycle including billing medical, dental and/or hospital claims. They are responsible for payer follow up and appealing of denied encounters to ensure accuracy of reimbursement. Essential Functions of the Job: Prepares accounts and encounters for accuracy for billing;...

Clinical Reimbursement Specialist

3 months ago


San Diego, United States Vi Living Full time
Overview:

Vi is recognized as a Great Place to Work and one of Glassdoor's 100 Best Companies to work for. Learn from the best and accelerate your career with Vi.

What We Offer:

  • Competitive pay
  • Exceptional benefits
  • Generous Paid Time Off - start accruing on day one
  • 401k with company match
  • Paid maternity and paternity benefits
  • Award-winning training and development
  • Tuition Reimbursement
  • Luxury work environment
  • Meaningful and rewarding work

 

Vi at La Jolla Village is located at 8515 Costa Verde Blvd, San Diego CA 92122

Responsibilities:

Clinical Reimbursement Specialist (CRS) – RN or LVN

 

Collaborates with the DON, CRM (where applicable) and various disciplines to assist in the completion of the Minimum Data Set (MDS), Resident Assessment Instrument (RAI), and all associated processes. With guidance and oversight from the DON or CRM (where applicable), the CRS ensures completion of the assessment within the timeframe as mandated by federal regulations and company policies. The CRS manages the overall resident assessment process and tracking of all Medicare/Managed Care/Medicaid case mix documents in order to ensure appropriate and optimal reimbursement for services provided within the Care Center. Responsibilities also include assisting with the coordination of resident care planning processes under the direction of the DON or CRM (where applicable). Performs other duties as assigned.

Qualifications: Education and Experience:
  • Education: Graduation from a School for Registered Nursing or Licensed Vocational Nurse is required.
  • Work Experience: Minimum 1 year of previous experience in an MDS/Clinical Reimbursement Nurse role is preferred.
  • Licensure / Certification, where required:
    • Current State Licensure as a Registered Nurse or Licensed Vocational Nurse in the state where practicing is required. Current CPR and Automated External Defibrillator (AED) certifications are required.
    • Current First Aid certification is required or must be willing and able to become First Aid certified. Food handlers certification, where required.
 Key Competencies:
  • Maintains a courteous and professional manner through interactions with others.
  • Uses a resident and customer-focused approach to problem solving and goal setting.
  • Uses discretion in handling confidential information, incorporating all Federal, State and local privacy and confidentiality requirements.
  • Excellent knowledge of case-Mix, and the Federal Medicare PPS process as required.
  • Thorough understanding of the Quality Indicator Process, and OBRA regulations.
  • Must possess knowledge of regulatory compliance and Continuing Care Retirement Community operations.
  • Good oral and written communication skills and ability to interface and maintain effective relationships with all departments and employees in a team-oriented environment.
  • Computer proficiency using Microsoft Office.
  • Must be sensitive to the needs of older adults and enjoy working with a senior population.

The application window is anticipated to close within 30 days of the date of the posting.

Pay Range: USD $38.00 - USD $52.63 /Hr.