Revenue Reimbursement Specialist, Full Time

Iredell Memorial Hospital IncorporatedStatesville, NC
1d

About The Position

The Revenue Reimbursement Specialist will be responsible for researching and analyzing accounts to diagnose reasons for under payment or non-payment of claims. Duties include ascertaining trends that emerge during review and help develop strategies to correct and ensure successful reimbursement. Monitor and investigate all governmental requests, including ADR’s, CERTS, MAC’s, and RAC’s, and all other revenue-driven denials and requests. Guides and coordinates with hospital staff s in developing responses. Identifies the need for changes in policies, procedures, documentation strategies, and protocols based on regulatory requirements and makes appropriate recommendations as indicated.

Requirements

  • 3- 5 years of related work experience required
  • Associates Degree in Finance, Business, Accounting or a Healthcare specific field preferred
  • Good communication skills
  • Proficiency in the use of a calculator, personal computers and business software (e.g., Word, Outlook, Excel, etc.).
  • Good working knowledge of Medicare, Medicaid, welfare agencies, insurances, etc. required.
  • Excellent problem solving skills
  • Comfortable with receiving challenging assignments and has the ability to flourish in stressful situations
  • Must possess full range of body motion to pass basic FIT test for position to include walking, kneeling, standing, pushing, pulling, bending, stooping, reaching and sitting for extended periods of time.
  • Must be able to lift and carry up to 30 pounds.

Nice To Haves

  • Associates Degree in Finance, Business, Accounting or a Healthcare specific field preferred

Responsibilities

  • researching and analyzing accounts to diagnose reasons for under payment or non-payment of claims
  • ascertaining trends that emerge during review and help develop strategies to correct and ensure successful reimbursement
  • monitoring and investigating all governmental requests, including ADR’s, CERTS, MAC’s, and RAC’s, and all other revenue-driven denials and requests
  • guiding and coordinating with hospital staff s in developing responses
  • identifying the need for changes in policies, procedures, documentation strategies, and protocols based on regulatory requirements and makes appropriate recommendations as indicated
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