Reimbursement Specialist

4 weeks ago


Harlingen, Texas, United States Prime Healthcare Full time
Overview

Prime Healthcare is a leading health system with a strong presence in the United States. With over 45 hospitals and 300 outpatient locations, we provide high-quality patient care and innovative healthcare solutions.

As a Reimbursement Specialist, you will play a critical role in ensuring accurate and timely payment analysis of managed care contracts. You will utilize complex regulations, guidelines, and systems to analyze payments received from insurance companies and ensure maximum and correct reimbursement receivables.

Responsibilities
  • Analyze payments received from insurance companies to assure maximum and correct reimbursement receivables
  • Proactively work with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment
  • Utilize and apply the appropriate regulations in order to assure compliance in payment practices
Qualifications
  • Minimum four years hospital billing and collection experience required
  • Medical and Insurance terminology essential
  • Knowledge of CPT, ICD-9, HCPCS coding structures
  • Experience with payment/EOB review
  • Bachelor's degree preferred

Prime Healthcare is an equal employment opportunity employer and prohibits discrimination against any applicant or employee based on race, color, sex, sexual orientation, gender identity, religion, national origin, age, disability, military status, genetic information, or any other basis protected by applicable federal, state, or local laws.



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