Prime Healthcare

Reimbursement Specialist

Facility Prime Healthcare Management Inc
Location
US-TX-Harlingen
ID
2022-105809
Category
Business Professional
Position Type
Full Time
Shift
Days
Job Type
Non-Exempt

Overview

Prime Healthcare is an award-winning 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 nation’s leading health systems with nearly 50,000 employees and physicians. Fourteen of the Prime Healthcare hospitals are members of the Prime Healthcare Foundation, a 501(c)(3) not-for-profit 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 in-house 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.

 

#LI-CG5

Qualifications

EDUCATION, EXPERIENCE, TRAINING

 

1.  Minimum four years hospital billing and collection experience required.

2.  Medical and Insurance terminology essential

3.  Knowledge of CPT, ICD-9, HCPCS coding structures

4.  Experience with payment/EOB review

5.  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

Options

Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Connect With Us!

Not ready to apply? Connect with us for general consideration.