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Clinical Reimbursement Specialist

2 weeks ago


Chesterfield, Missouri, United States The Westchester House Full time

The Westchester House is seeking a highly skilled Clinical Reimbursement Specialist to ensure accurate and timely reimbursement for services provided to patients and residents covered by insurance programs. The ideal candidate will have experience reviewing patient records and clinical care programs in accordance with applicable laws, regulations, and standards.

Key Responsibilities:

  • Review patient records and clinical care programs to ensure correct reimbursement
  • Make independent decisions when circumstances warrant such action
  • Knowledgeable of practices and procedures governing functions in the post-acute care facility
  • Implement and interpret programs, goals, objectives, policies, and procedures of the department

Requirements:

  • Registered nurse with an active state license and MDS and RAI experience
  • Maintain professional working relationships with associates, vendors, etc.
  • Confidentiality of proprietary and/or confidential information
  • Understand and follow company policies including harassment and compliance procedures