Reimbursement Specialist
Reimbursement Specialist
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1 Vacancy
Job Description
Overview
Prime Healthcare is an awardwinning health system headquartered in Ontario California. Prime Healthcare operates 45 hospitals and has more than 300 outpatient locations in 14 states providing more than 2.6 million patient visits annually. It is one of the nations leading health systems with nearly 50000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation a 501(c)3 notforprofit public charity. Prime Healthcare is actively seeking new members to join our corporate team!
Responsibilities
Under the supervision of the PFS Director the Reimbursement Specialist position is the lead responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations guidelines and systems analyzes payments received from insurance companies to assure maximum and correct reimbursement receivables. Proactively works with payers and inhouse resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices.
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Qualifications
Education and Work Experience
- Minimum four years hospital billing and collection experience required.
- Medical and Insurance terminology essential.
- Knowledge of CPT ICD9 HCPCS coding structures.
- Experience with payment/EOB review.
- Bachelors degree preferred
Company is an equal employment opportunity employer. Company prohibits discrimination against any applicant or employee based on race color sex sexual orientation gender identity religion national origin age (subject to applicable law) disability military status genetic information or any other basis protected by applicable federal state or local laws. The Company also prohibits harassment of applicants or employees based on any of these protected categories. Know Your Rights: Experience:
Unclear Seniority
Employment Type
Full-Time
Key Skills
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