Network Reimbursement Specialist

1 month ago


Buffalo, New York, United States Independent Health Full time
Job Summary

We are seeking a highly skilled Network Reimbursement Specialist to join our team at Independent Health. As a key member of our organization, you will play a critical role in ensuring accurate and timely reimbursement of our practitioner community.

Key Responsibilities
  • Comprehensive understanding of Independent Health reimbursement policies and professional reimbursement methodologies
  • Research, analyze, and resolve complex professional practitioner processing issues
  • Exercise independent judgment in claims processing determinations
  • Conduct self-directed research and claim reviews to audit proper application of reimbursement policies
  • Develop and maintain professional reimbursement SOPs, documented processes, and decision-making trackers
  • Collaborate with associates on the Facility Reimbursement team to ensure consistent processing of services
  • Recommend and assist in the implementation of process improvements that lead to administrative savings and efficiency for the department
Requirements
  • High School diploma or GED required; Associates degree preferred
  • Three (3) years of reimbursement experience in the healthcare industry required with expertise in industry standard claims edits and correct coding requirements
  • Has obtained and maintained the certification of Certified Professional Coder, American Academy of Professional Coders
  • Strong working knowledge of CPT, ICD-9-CM, ICD-10-CM, and HCPCS coding systems
  • PC and Windows skills including Microsoft Word, Excel, Access, and Internet navigation skills
  • Strong analytical skills
  • Proven ability to assume responsibility and work independently
  • Ability to accomplish daily tasks with little to no direct oversight
  • Ability to represent the department at cross-functional teams and engage meaningfully
  • Effective written and verbal communication skills
  • Ability to maintain confidentiality
  • Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, and Accountable
What We Offer
  • Competitive compensation package
  • Full range of benefits
  • Generous paid time off
  • Opportunities for professional growth and development
How to Apply

Current associates must apply internally via the Job Hub app. We are an equal opportunity employer and welcome applications from diverse candidates. We are committed to creating a safe and inclusive work environment.



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