Reimbursement Specialist - Healthcare jobs in Michigan
Reimbursement Specialist - Healthcare determines the extent to which patients' insurance covers their treatments. Reviews appropriateness of CPT-4/ICD-10 coding and determines if care provided corresponds to the charges submitted. Being a Reimbursement Specialist - Healthcare ensures compliance with Federal and State regulations and company policies that govern Medicare and state payment systems. May assist in identifying fraudulent non-plan billing practices and assists the legal department with litigation preparation. Additionally, Reimbursement Specialist - Healthcare may require a bachelor's degree. Typically reports to a supervisor or manager. Typically requires Certified Professional Coder (CPC) from AAPC or AHIMA. The Reimbursement Specialist - Healthcare gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Reimbursement Specialist - Healthcare typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)
Recently Added Reimbursement Specialist - Healthcare jobs
Reimbursement Specialist- Govt Programs
- Bronson Healthcare
-
Bronson, MI
FULL_TIME
-
CURRENT BRONSON EMPLOYEES - Please apply using the career worklet in Workday. This career site is for external applicants only.
Love Where You Work!
Team Bronson is compassionate, resilient and strong. We are driven by Positivity which inspires us to be our best and to go above and beyond for our patients, for one another, and for our community.
If you’re ready for a rewarding new career, join Team Bronson and be part of the experience.
Location
BHG Bronson Healthcare Group
Title
Reimbursement Specialist- Govt Programs
Performs duties necessary to facilitate payment from third party payers. This includes correct billing, statusing and collection from third parties, posting third party payments (if applicable), computing correct reimbursement, processing incoming and outgoing correspondence, and maintaining a working knowledge of current contracts and government regulations for multiple entities. Employees providing direct patient care must demonstrate competencies specific to the population served.
High school diploma or general education degree (GED) required. Associate's degree in business or Finance; or equivalent experience in Hospital or Professional billing. Successfully pass EUPA's for all Epic applications associated with position within the first 90 days in the position- Strong computer and general office equipment knowledge required.
- Knowledge of medical terminology, ICD-10 and CPT-4 coding, National Billing forms, third-party payers, managed care, reimbursement and regulatory compliance preferred.
- Ability to type 45 words per minute is necessary.
- Must be an effective communicator with patients, customers and co-workers.
- Must be able to quickly analyze communication style based on nature and approach of verbal inquiry. Work which produces very high levels of mental/visual fatigue, e.g. CRT work between 70 and 90 percent of the time, and work involving extremely close tolerances and considerable hand/eye coordination for sustained periods of time. The job produces some physical demands. Typical of jobs that include regular walking, standing, stooping, bending, sitting, and some lifting of light weight objects.
- Accountable for ensuring claims are compliant with all payer specifications; State, Federal and HIPAA regulations.
- Resolves billing issues up front to promote better reimbursement, reduce outstanding revenue and time spent on working rejections or additional claim follow up.
- Prepares documentation to maximize reimbursement.
- Analyze assignment of all CPT-4, ICD-10, UB04, HCFA 1500 and charges for accuracy and to maximize reimbursement from third party payers
- Critically analyze and process third party and internal information requests and rejections in an effort to resolve accounts receivable.
- Critically analyze and process documents for resolution of third party liabilities, outstanding credits and un-billed accounts.
- Make all necessary posting, adjustments and refunds to accounts and critique contractual allowances and other arrangements.
- Responsible for complete understanding and application of current contracts and governmental regulations including referrals for legal intervention for multiple entities.
- Proficient in the revenue cycle process via multiple computer systems including but not limited to: Internal systems: STAR, EC2000, EPIC, SSI, GLMI Home Health Billing system and External systems such as payer claims and eligibility systems.
- Verifies insurance eligibility using automated on-line systems.
First Shift
Time Type
Full time
Scheduled Weekly Hours
40
Cost Center
1205 Pt Acctg - Govt Programs (BHG)
Agency Use Policy and Agency Submittal Disclaimer
Bronson Healthcare Group and its affiliates (“Bronson”) strictly prohibit the acceptance of unsolicited resumes from individual recruiters or third-party recruiting agencies ("Recruiters") in response to job postings or word of mouth. Unsolicited resumes sent to any employee of Bronson by Recruiters, without both a valid written agreement with Bronson and a direct written request from the Bronson Talent Acquisition Department for a specific job position, will be considered the property of Bronson. Furthermore, no fees will be owed or paid to Recruiters who submit resumes for unsolicited candidates, even if those candidates are hired. This policy applies regardless of whether the Recruiter has a pre-existing agreement with Bronson. Only candidates submitted through a specific written agreement with the Bronson Talent Acquisition Department for a named position are eligible for fee consideration.
Please take a moment to watch a brief video highlighting employment with Bronson! - 8 Days Ago
Reimbursement Specialist- Comm/Mgd Care
- Bronson Healthcare
-
Bronson, MI
FULL_TIME
- CURRENT BRONSON EMPLOYEES - Please apply using the career worklet in Workday. This career site is for external applicants only.Love Where You Work!Team Bronson is compassionate, resilient and strong. ...
- 8 Days Ago
Healthcare Reimbursement Accounting Consultant - Winter Intern (2025)
- Plante Moran
-
Southfield, MI
INTERN
- Location: United States, Michigan, Southfield Location: United States, Ohio, Cleveland Location: United States, Ohio, Columbus Make your mark. Within our management consulting group, our reimbursement...
- 13 Days Ago
Billing and Reimbursement Specialist* 40hr/wk
- umhealthwest
-
Wyoming, MI
FULL_TIME
- Billing and Reimbursement Specialist* 40hr/wk Requisition #: req7767 Shift: Days FTE status: 1 On-call: No Weekends: No General Summary: A Billing and Reimbursement Specialist is responsible for the a...
- 6 Days Ago
Outreach Reimbursement Specialist
- McLaren Health Care Corporation
-
Flint, MI
FULL_TIME
- Position Summary: Responsible for ensuring that all laboratory outreach documentation necessary for billing and compliance is processed in a timely and accurate manner. This includes obtaining all nec...
- 27 Days Ago
Field Reimbursement Specialist
- Syneos Health Commercial Solutions
-
Detroit, MI
FULL_TIME
- Description You are an expert facilitator: you open doors, foster communication, and bridge the gap. In this role, you will be responsible for the management of defined accounts in a specified geograp...
- 30 Days Ago
Reimbursement Specialist - Healthcare jobs at Popular Companies
Reimbursement Specialist
- Randstad Life Sciences
-
Tempe, AZ
- Job Description Job Description Job Description Provides mission critical support to company brands by helping patients ...
- 6/11/2024 12:00:00 AM
Reimbursement Specialist
- Randstad Life Sciences
-
Tempe, AZ
- Job Description Job Description Job Description The Reimbursement Specialist will be responsible for providing support a...
- 6/11/2024 12:00:00 AM
Reimbursement Specialist
- Synergy Orthopedics
-
Plymouth Meeting, PA
- Job Description Job Description Objective: The Reimbursement Specialist will be expected to follow up on open claims and...
- 6/10/2024 12:00:00 AM
Reimbursement Specialist
- Randstad Life Sciences
-
East Hanover, NJ
- Job Description Job Description Title: Reimbursement Specialist 1 Duration: 6 months Pay Rate : $27.50/hr on W2 Location...
- 6/10/2024 12:00:00 AM
Reimbursement Specialist- Collections
- BMR Partners Inc
-
Orange, CA
- Job Type Full-time Description The Reimbursement Specialist is responsible for assisting the Reimbursement Supervisor in...
- 6/10/2024 12:00:00 AM
Reimbursement Specialist
- Prompt Care Companies Inc
-
New Providence, NJ
- Job Type Full-time Description PromptCare is seeking a highly motivated and detail-oriented Reimbursement Specialist to ...
- 6/8/2024 12:00:00 AM
Reimbursement Specialist
- Vinfen
-
Cambridge, MA
- Schedule: Mon-Fri 9am-5pm (2 days remote after training) Salary: $23.00-$25.00 / hour The Reimbursement Specialist is ch...
- 6/8/2024 12:00:00 AM
Reimbursement Specialist
- University Health System- San Antonio
-
San Antonio, TX
- POSITION SUMMARY/RESPONSIBILITIES Identifies and enrolls indigent and under-insured patients into drug assistance reimbu...
- 6/8/2024 12:00:00 AM
About Michigan
Michigan consists of two peninsulas that lie between 82°30' to about 90°30' west longitude, and are separated by the Straits of Mackinac. The 45th parallel north runs through the state—marked by highway signs and the Polar-Equator Trail—along a line including Mission Point Light near Traverse City, the towns of Gaylord and Alpena in the Lower Peninsula and Menominee in the Upper Peninsula. With the exception of two small areas that are drained by the Mississippi River by way of the Wisconsin River in the Upper Peninsula and by way of the Kankakee-Illinois River in the Lower Peninsula, Michigan...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$44,664 to $54,274
Most Popular Cities in Michigan for Reimbursement Specialist - Healthcare Jobs
What does a Reimbursement Specialist - Healthcare do?
Reimbursement Specialist - Healthcare in Dayton, OH
Accurate and efficient reimbursement adds value to all health care providers; and certified professional coders can help deliver that.
January 04, 2020
Reimbursement Specialist - Healthcare in Ventura, CA
Specialised mental healthcare includes diagnosis and specialist treatment of (highly) complex psychological disorders such as psychiatrists and clinical psychologists generally provide.
February 07, 2020
Reimbursement Specialist - Healthcare in Florence, AL
Through MedCert’s 22-week program, you will find yourself equipped to serve as a Reimbursement and EHR Health Specialist as well as prepared to gain certification as a Certified Electronic Health Records Specialist (CEHRS) and a Certified Billing and Coding Specialist (CBCS) providing needed support to healthcare providers.
December 15, 2019