Reimbursement Specialist - Healthcare jobs in Indiana
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
MDS Reimbursement LVN or RN
- Outfield Healthcare Partners
-
Brownsburg, IN
FULL_TIME
-
Job Type: Full-Time
Benefits Offered:- Healthcare
- Dental
- Vision
- PTO
- 401K
The MDS Coordinator will be responsible for timely and accurate completion of both the RAI process and care management process from admission to discharge in accordance with company policy and procedures, and Federal, State and Certification guidelines, and all other entities as appropriate- Minimum Data Set, discharge and admission tracking, etc. With direction from the Director of Nursing and VP of Clinical Reimbursement, may coordinate information systems operations and education for the clinical department.
Principal Responsibilities- Works in collaboration with the Interdisciplinary Team to assess the needs of the resident; Provides interdisciplinary schedule for MDS assessments and care plan reviews as required by governing agencies.
- Ensures that the Interdisciplinary team makes decisions for either completing or not completing additional MDS, assessments based on clinical criteria as identified in the most recent version of the RAI User’s Manual.
- Assist with coordination and management of the daily stand up meeting, to include review of resident care and the setting of the assessment reference date(s).
- Complies with federal and state regulations regarding completion and coordination of the RAI process.
- Monitors MDS and care plan documentation for all residents; ensures documentation is present in the medical record to support MDS coding.
- Maintains current MDS status of assigned residents according to state and federal guidelines.
- Maintains the frequent and accurate data entry of resident information into appropriate computerized MDS programs.
- Completes accurate coding of the MDS with information obtained via medical record review as well as observation and interview with facility staff, resident and family members.
- Attends interdisciplinary team meeting, quality assurance and other meeting in order to gather information, communicate changes, and maintain and update records.
- Assists DON or designee with identification of a significant change, physician orders and verbal reports to assure that the MDS and care plan are reflective of those changes.
- Prepares scheduling, notice of resident care planning conferences, and assists DON in communication of outcomes/problems to the responsible staff, resident, and/or responsible party.
- Continually updating knowledge base related to data entry and computer technology.
- Completes electronic submission of required documentation to the state database and other entities per company policy.
- Corrects and ensures completion of final MDS and submits resident assessment data to the appropriate State and Federal government agencies.
- Assigns, assists, and instructs staff in the RAI Process, PPS Medicare, Medicaid (Case Mix as required) and clinical computer system in relation to these processes.
- Maintains confidentiality of necessary information.
- Other duties, responsibilities and activities may change or assigned at any time with or without notice.
- Graduate of an approved Registered Nurse program and licensed in the state of practice, required.
- Minimum of 2 years of nursing experience in a Skilled Nursing Facility preferred.
- Excellent knowledge of Case-Mix, the Federal Medicare PPS process, and Medicaid reimbursement, as required.
- Thorough understanding of the Quality Indicator process. Knowledge of the OBRA regulations and Minimum Data Set.
- Knowledge of the care planning process.
- Experience with MDS 3.0, preferred.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. - 15 Days Ago
Claims Reimbursement Specialist
- Remodel Health
-
Indianapolis, IN
FULL_TIME
- Benefits Specialist Job Description Remodel Health has helped employers to revolutionize the way health benefits are delivered to their employees since 2014. We’ve made it to the Inc 5000 list 5 years...
- 2 Days Ago
Healthcare Specialist
- Evansville Vanderburgh School Corporation
-
Evansville, IN
FULL_TIME
- Our people are the single most important asset we have in the EVSC. - Dr. Smith, Superintendent Join a school district where employees are truly making a difference in the lives of students each day. ...
- 23 Days Ago
Faculty - Healthcare Specialist
- Ivy Tech Community College of Indiana
-
Fort Wayne, IN
FULL_TIME
- Provide quality and engaging instruction in all delivery methods and formats within specific academic programs; provide timely and meaningful feedback to students regarding the mastery of course and p...
- 28 Days Ago
Adjunct Faculty - Healthcare Specialist
- Ivy Tech Community College of Indiana
-
Indianapolis, IN
PART_TIME
- Job Description Summary Adjunct Faculty positions are temporary, part-time positions hired each semester on an as-needed basis. The adjunct faculty member will be responsible for creating a learning e...
- 6 Days Ago
Substitute Healthcare Specialist
- Evansville Vanderburgh School Corporation
-
Evansville, IN
FULL_TIME
- Healthcare Specialist Substitutes Substitutes are a integral part of the Evansville Vanderburgh School Corporation. We rely and appreciate the dedication of our substitutes. Make a difference in the l...
- 20 Days Ago
Reimbursement Specialist - Healthcare jobs at Popular Companies
Reimbursement Specialist
- Planned Parenthood Mar Monte
-
San Jose, CA
- Reimbursement SpecialistFull-TimeHybrid/Remote ESSENTIAL DUTIES Review Government and Non-Government Payer claims for ac...
- 6/2/2024 12:00:00 AM
Senior Reimbursement Specialist
- Northwest Georgia Oncology Centers, PC
-
Marietta, GA
- Job Description Job Description Busy oncology practice has an immediate opening for a Senior Reimbursement Specialist. P...
- 6/2/2024 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...
- 5/31/2024 12:00:00 AM
Reimbursement Specialist
- Nemours Children's Health
-
Jacksonville, FL
- Job Description Nemours is seeking Reimbursement Specialist (Full-Time), to join our team in Jacksonville, Florida. This...
- 5/31/2024 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...
- 5/31/2024 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...
- 5/29/2024 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 ...
- 5/29/2024 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...
- 5/29/2024 12:00:00 AM
About Indiana
Indiana /ˌɪndiˈænə/ (listen) is a U.S. state located in the Midwestern and Great Lakes regions of North America. Indiana is the 38th largest by area and the 17th most populous of the 50 United States. Its capital and largest city is Indianapolis. Indiana was admitted to the United States as the 19th U.S. state on December 11, 1816. Indiana borders Lake Michigan to the northwest, Michigan to the north, Ohio to the east, Kentucky to the south and southeast, and Illinois to the west.
Before becoming a territory, various indigenous peoples and Native Americans inhabited Indiana for thousands of ye...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Reimbursement Specialist - Healthcare jobs
$43,793 to $53,217
Most Popular Cities in Indiana 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