Reimbursement Specialist I

Sarasota Memorial Health Care System • Sarasota, FL

88d

About The Position

The Revenue Cycle department is seeking an administrative support specialist responsible for the accurate and timely posting of charges related to Surgery, Emergency Room (ECC), hospital-wide observation, and Delivery/High Risk Antepartum/Testing/Triage. This role operates under the direction and supervision of Revenue Cycle Management, ensuring compliant charging practices for all payors by reviewing medical records for appropriate clinical documentation that supports the accuracy of charges. The specialist will assist in the review and resolution of charge Correct Coding Initiative (CCI) edits and will also act as a mentor and trainer to other Reimbursement Specialists.

Requirements

• Minimum of two (2) years of health care experience involving charging practices and patient flow processes.
• Current coding certification can substitute for the required experience.

Nice To Haves

• Coding certification is preferred.
• Clinical certification from a recognized health care credentialing organization in a specialty area (i.e., RRA, RT, VI, CI, RCIS, RVS, CSFA, CST) is preferred.
• Demonstrated interpersonal and communication skills are preferred.
• Working knowledge of commonly used computer applications is required.
• Ability to work with minimal supervision is preferred.
• Demonstrated proficiency with medical terminology is preferred.
• Demonstrated proficiency with specific charging and coding as it applies to various departments (i.e. Surgery, Emergency Room, Observation, or Delivery/High Risk Antepartum/Testing/Triage) is preferred.

Responsibilities

• Accurately post Surgery, Emergency Room, observation, and Delivery/High Risk Antepartum/Testing/Triage charges.
• Review medical records for appropriate clinical documentation to support charge accuracy.
• Assist in resolving Surgery, Emergency Room, Observation, or Delivery/High Risk Antepartum/Testing/Triage charge CCI edits.
• Mentor and train other Reimbursement Specialists.

What This Job Offers

• Industry: Hospitals
• Education Level: High school or GED