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Reimbursement Specialist
2 months ago
Job Summary:
The Reimbursement Specialist position is a critical role within Prime Healthcare Management Inc, responsible for ensuring accurate and timely payment analysis of managed care contracts. This position requires a high level of expertise in complex regulations, guidelines, and systems to determine optimal reimbursement.
Key Responsibilities:
- Under the supervision of the PFS Director, lead the analysis of payments received from insurance companies to ensure maximum and correct reimbursement receivables.
- Utilize knowledge of CPT, ICD-9, HCPCS coding structures to analyze payments and identify areas for improvement.
- Proactively work with payers and in-house resources to resolve issues hindering optimal account payment.
- Ensure compliance with payment practices by applying relevant regulations and guidelines.
Requirements:
- Minimum four years of experience in hospital billing and collection.
- Essential knowledge of medical and insurance terminology.
- Experience with payment/EOB review and analysis.
- Bachelor's degree preferred.
Why Join Our Team:
As a Reimbursement Specialist at Prime Healthcare Management Inc, you will have the opportunity to work with a dynamic team of professionals dedicated to delivering high-quality patient care. Our company is committed to providing a supportive and inclusive work environment that fosters growth and development.
