Reimbursement Specialist (80569)
HybridJacksonville, North Carolina, United States
Job Summary
Communicate reimbursement best practices, regulatory trends, and related matters to leadership while supporting the evolving reimbursement program. Oversee data gathering, financial modeling, and ad hoc financial reports for managed care contracting to validate claim payments and identify revenue-enhancing opportunities. Maintain and audit the financial models in the database system for accurate reporting, investigate over and under payments for claims variances, and participate in departmental special projects. Requires a Bachelor's degree or equivalent experience in billing, coding, and healthcare data analysis.
Required Qualifications
- Associates degree in business or healthcare field and three (3) years billing, and/or coding experience
- If high school diploma, then at least six (6) years billing, and/or coding experience
- Experience in billing or coding in a healthcare organization
- Data analysis and reporting
- Billing/Collections
- Insurance Claims
- Microsoft Office
- good communication skills
Desired Qualifications
- Bachelor's degree in an appropriate discipline
- Two (2) years of analysis in financial, reimbursement modeling or healthcare data or managed care negotiations with a healthcare organization, provider group, or health plan/payer
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