Under the supervision of the Director of Reimbursement, a Reimbursement Specialist is responsible for accurate and timely payment analysis by comparing EOBs to contracted rates and determining if appropriate reimbursement is received from insurance companies. Ensure adjustments and write-offs are submitted regularly and appropriately investigated for accuracy before approval from Director. Maintain a clear and concise understanding of the different adjustments and rationale for use. Proactively works with in-house resources to identify trends and resolve issues that hinder optimal and correct account payment that need to be escalated to insurance companies. Performs duties in accordance with Prime Healthcare values, policies, and procedures. Other duties as assigned to support the unit, department, entity, and health system.
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