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)
Company: Community Care Network of Kansas
Job Title: Healthcare Policy Specialist
Job Classification: Full-Time, Exempt
Supervisor: Policy Director
Salary Range: Negotiable based on experience
Schedule: Monday through Friday, 8:00 am to 5:00pm (or similar schedule)
Location: Topeka, KS
Who We Are:
Community Care Network of Kansas (Community Care) strives to ensure all Kansans have access to quality, community‐based healthcare close to home. We are a statewide association made up of a network of community clinics, all dedicated to providing the best medical, dental and behavioral care to Kansans.
Together, we are leaders in healthcare training, technical assistance, and public policy. We collaborate with healthcare associations, providers, foundations and individuals to educate and advocate for equitable access to high‐quality care for all. We believe healthy Kansans build strong and vibrant communities, which strengthens the overall quality of life in our great state.
Primary Accountabilities:
The Healthcare Policy Specialist will work with a team of Community Care staff, the Board of Directors, the Legislative Committee, and member clinics to help align state and federal policy with member clinic goals and outcomes. This position has a specific focus on legislative, regulatory, and/or administrative financial or workforce policy that increases or hinders access to care.
Major Responsibilities:
Qualifications:
Physical Demands:
Work Environment:
Additional Duties: Additional duties and responsibilities may be added to this job description at any time. The job description does not state or imply that these are the only activities to be performed by the employee(s) holding this position. Employees are required to follow any other job-related instructions and to perform any other job-related responsibilities are requested by their supervisor.