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Guthrie · 1 day ago

Reimbursement Specialist - Corporate Reimbursement/Coding - Full Time

Pennsylvania, United States

Full-time

Onsite

Mid Level

3+ years exp

Guthrie is seeking a Reimbursement Specialist to provide technical expertise in documentation guidelines, coding, and reimbursement. The role involves educating providers and staff to ensure compliance with billing guidelines and promoting revenue integrity processes within the organization.

Health CareHospitalPersonal Health

Growth Opportunities

Responsibilities

Develop and provides education to physicians, residents, office staff, and others throughout the organization that may require coding knowledge

Perform clinical and coding reimbursement assessments to ensure revenue capture. Make recommendations to appropriate providers, staff, and leadership partners

Communicate with all parties involved the results of quality coding/documentation reviews

Research coding and billing guidelines and assisting Managers/Providers/Staff with coding related rejections and WQ edits. Recommend process improvements or educate staff to prevent future rejections

Works collaboratively with centralized inpatient coder and central charge entry to ensure all charges are captured

Perform special audits upon request to analyze billing activity

Ensure all regulations are met and claims subsequently submitted to payers accurately

Contribute to maintaining a team environment. Must work in a way that demonstrates and promotes teamwork

Maintains confidentiality regarding patient accounting

Performs other duties as assigned

Qualification

RHIA certificationRHIT certificationCCS certificationCPC certificationCPT codingICD-10-CM codingHCPCS codingMedicare knowledgeMedicaid knowledgeMedical terminologyAnatomy knowledgePhysiology knowledgeEpic proficiencyExcel proficiencyWord proficiencySystem Reports proficiencyTeaching experienceVerbal communicationProblem-solvingTeamwork

Required

High School Diploma or equivalency required

Degree in Health Information Technology or possession of RHIA, RHIT, CCS, or CPC certification required

Minimum three years' experience in physician coding and reimbursement

Must have comprehensive knowledge of Medicare, Medicaid, and other third‐party payer coding and billing regulations

Must be able to demonstrate a strong knowledge of CPT, ICD‐10‐CM and HCPCS coding systems and guidelines, medical terminology, anatomy, and physiology

Demonstrate strong verbal and communication skills

Teaching and/or training experience required

Strong analytical abilities and problem‐solving skills required

Proficient computer skills: Epic, Word, Excel, and System Reports