Clinical Reimbursement Reviewer
7 days ago
**About the Opportunity:**
We are seeking a skilled Clinical Reimbursement Specialist to join our team at MedicalWorx Staffing. This is a full-time opportunity with a competitive salary range of $70,000-$90,000 per year, depending on experience.
As a Clinical Reimbursement Specialist, you will be responsible for reviewing and analyzing medical claims to ensure accurate reimbursement. Your expertise in healthcare billing, coding, and collections will be essential in this role. With 2-4 years of experience in denials management, you will be able to effectively validate appeal intake determinations and analyze claim coding and processing history.
You will also collect and catalog supporting documentation, formulate an appeal recommendation, and document information in appropriate systems. Strong communication and organizational skills are required to present complex medical and reimbursement information to others and to prioritize work to meet strict timelines.
**Responsibilities:**
- Review and analyze medical claims to ensure accurate reimbursement
- Validate appeal intake determinations and analyze claim coding and processing history
- Collect and catalog supporting documentation and formulate an appeal recommendation
- Document information in appropriate systems
- Present complex medical and reimbursement information to others
- Prioritize work to meet strict timelines
**Requirements:**
- High school diploma or GED from an accredited institute
- 2-4 years of experience in healthcare billing, coding, collections, payment processing, or denials management
- Professional certifications related to Coding, Billing, Accounting, Patient Representative, or another related field preferred
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