Posted in General Business 30+ days ago.
Type: Full-Time
JOB SUMMARY:
The Reimbursement Specialist, under the general direction of the Reimbursement Strategy Manager, is responsible for working closely with the Reimbursement Strategy Manager and other members of the Network Strategy Team on projects. This individual will assist in providing sound, financial and statistical analyses to support the real-time decision-making needs of enterprise leadership. The Healthcare Reimbursement Specialist must be skilled in evaluating, examining, optimizing, and translating into business requirements all healthcare payor contracts for the enterprise. Responsibilities will also include ensuring that all claims processing and valuation systems are properly configured, maintained, and monitored constantly to ensure a high degree of compliance and accuracy with reimbursement terms and policies outlined in payor agreements. The team member, independently and within cross-functional teams, will assist in providing highly reliable and dependable analysis for unique and new opportunities, detect and communicate improvement opportunities in existing reimbursement operations, and support the analysis, improvement, and creation of management metrics, reports, alerts, and dashboards as applicable to revenue cycle operations. Ideal candidate is expected to have a firm understanding of healthcare and payor operations, reimbursement strategies, and healthcare payor contracts and agreements.
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