Healthcare Reimbursement Specialist

20 hours ago


Roseville, California, United States Adventist Health Full time

About Us

At Adventist Health, we strive to provide high-quality patient care while maintaining a commitment to compassion and respect.

We are currently seeking a Healthcare Reimbursement Specialist to join our team in Sacramento, California.

The estimated salary for this position is $80,000 - $105,000 per year, depending on experience.

Job Description

This role will be responsible for researching payer clinical denials related to referral, pre-authorization, medical necessity, case management, non-covered services, and billing resulting in denials and delays in payment.

This includes maintaining confidentiality of information in compliance with hospital policies and HIPAA.

Required Skills and Qualifications

  • Associate's Degree in Nursing: Required
  • Bachelor's Degree in Nursing (BSN): Preferred
  • Three years' experience in an Acute Care Hospital: Preferred
  • Three years' experience in Utilization Management/Case Management, or related field: Preferred
  • Three years' experience with InterQual and/or MCG for acute care hospital population: Preferred

Benefits

  • Comprehensive benefits package
  • Generous paid time off
  • Professional development opportunities

Others

  • Must have strong analytical skills and attention to detail


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