Reimbursement Specialist

Certified Professional Coder (CPC). Must be a member in good standing of the American Academy of Professional Coders and maintain biannual continuing education credits (36) to solidify up-to-date knowledge and understanding of professional medical coding.
Certificate of ICD-10-CM Proficiency for diagnosis coding is required.
Apply correct coding guidelines to multiple source system entries for coding and charge entry.
Timely and accurate completion of day-to-day processing of all clinic and procedural coding and charge entry for multiple interfaced systems.
Assist team lead in defining and submitting RCx rules for consideration to streamline coding accuracy and efficiency within multiple interfaced systems.
Knowledge of insurance, managed care, Medicaid and Medicare regulatory requirements.
Strong attention to detail and critical thinking skills.
Strong organizational and time management skills.
Assist in data analysis and development of logical solutions to coding and reimbursement problems.
Interface effectively and cooperatively with computer system and their Users to maintain efficient system utilization; recommend appropriate revisions to processes, procedures, and operations.
Assist with testing and implementation of third-party vendor applications software.
Ability to work well with people from different disciplines with varying degrees of business and technical expertise.
Good interpersonal relationship skills.

Must be able to adapt to a large, complex, multi-system business environment, confer with both internal and external customers and vendors and assist in managing the expectations of a diverse and demanding User constituency.
Work with the team lead within assigned departments to support and streamline day to day workload.
Must have extensive knowledge of clinic and procedure based coding.
Assist in creating and updating policies and procedures to be used within the designated departments.
Work department reports and assigned work queues and bring feedback to coding team lead to ensure proper coding and avoid future delays in payment.
Work with minimal supervision on assignments.
Identify any coding or payer changes and bring that information to the team lead and providers to ensure proper coding.
Supports development tools, procedures and methods for daily operational support.
Works with the team lead on routine, well defined, analysis type problems related to coding and reimbursement.
Fulfills department requirements in terms of providing work coverage and administration notification during periods of personnel illness, vacation or education.
Maintain HIPAA confidentiality at all times.
Other duties or assignments as designated by management.

No preferred qualifications provided.