Reimbursement Specialist

Job Description

Job Description

POSITION SUMMARY :

Under the supervision of the Corporate Director of Insurance Contracts / Charge Master Analyst the Reimbursement Specialist responsibilities include :

• Maintaining and updating the Chargemaster to comply with federal and state regulations and internal hospital policies. Coordinate with Department Managers and / or Practice Mangers to assure all necessary charges are built in the Chargemaster and perform audits to evaluate if all charges are being captured.
• Responsible as the managed care subject matter expert. Investigates and resolves managed care reimbursement issues identified by the facilities or payers, including fee schedule and reimbursement loading of contracts accuracy in system. Maintains payer summary matrix. Analyzes contractual payments for opportunities. Coordinate and communicate contractual terms to the billing and collection departments; ensure staff is informed of changes in medical policy & billing policies.

QUALIFICATIONS :

NOTE : Candidate MUST reside in the state of Louisiana and be able to travel to the nearest CBO location for training and other necessary requirements.

SKILLS PREFERRED :

Basic computer skills required.

PHYSICAL AND MENTAL REQUIREMENTS :

Physical : Walking - up to 50% Standing - up to 40% Kneeling - up to 1%

Sitting - up to 50% Pushing - up to 5% Bending - up to 5%

Squatting - up to 5% Pulling - up to 5% Reaching - up to 10%

Lifting - up to 25lbs. Wrist / Finger Movements - up to 80%

Mental : Stress Level : Moderate to High