Prime Healthcare is an award-winning national hospital system with 45 acute-care hospitals in 14 states with nearly 50,000 employees and physicians. Through a physician-directed and patient-centered model, passionate dedication to quality, evidence-based best practices, operational efficiency, technology and capital investment, our hospitals are recognized among the best in the nation. Prime Healthcare has been named a “Top 15 Health System” by Truven and our hospitals are consistently among the “Top 100 Hospitals” in the country.
Under the supervision of the Manager, the Reimbursement Specialist is responsible for accurate and timely payment analysis of managed care contracts to determine that the appropriate reimbursement is received. Please apply today!
Responsibilities:
Utilize many complex and varying regulations, guidelines and systems to analyze payments received from insurance companies.
Ensure maximum and correct reimbursement receivables.
Proactively work with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment.
Utilize and apply the appropriate regulations in order to ensure compliance in payment practices.
Qualifications:
2+ years hospital billing and collection experience required.
Medical and Insurance terminology essential.
Knowledge of CPT, ICD-9, HCPCS coding structures.
Experience with payment/EOB review
Associates or Bachelor's degree preferred
We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf
Seniority level
Associate
Employment type
Full-time
Job function
Accounting/Auditing and Finance
Industries
Wellness and Fitness Services, Medical Practices, and Hospitals and Health Care
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