Prime Healthcare

Reimbursement Specialist (RS1) - PHMI New Jersey B.O.

Facility Prime Healthcare Management Inc
Location
US-NJ-Denville
ID
2021-75594
Category
Business Professional
Position Type
Full Time
Shift
Days

Responsibilities

Under the supervision of the 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.

Qualifications

Education and Work Experience

  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

 

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