Reimbursement Coordinator, Intermediate

🕒 il y a 9 jours

🔔 Pennsylvania – Distant

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⏰ Temps Plein

🟠 Senior

🔴 Expert

🗣️🇺🇸🇬🇧 Anglais requis

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Logo of Geisinger

Geisinger

10 000+ employés

Fondée en 1915

🏥 Santé

💊 Pharmaceutique

🧘 Bien-être

Healthcare • Pharmaceuticals • Wellness

Geisinger est une organisation de santé qui dessert les communautés de Pennsylvanie depuis plus d'un siècle, fournissant des services médicaux essentiels et des solutions de santé innovantes. L'organisation met l'accent sur la diversité, le développement de carrière et la création d'un environnement de soutien pour ses employés, tout en s'efforçant d'améliorer la santé et le bien-être de ses patients grâce à divers programmes et initiatives communautaires. Geisinger est reconnu comme l'un des systèmes de santé les plus innovants, et s'engage à façonner l'avenir de la santé en se concentrant sur les soins aux patients et l'inclusivité.

Description

• Serve as a consultant and educator to staff and administration on reimbursement, strategic savings initiatives, and coding compliance • Assess existing and prospective reimbursement practices • Recommend appropriate reimbursement based on contracts, policies, and industry practices • Provide consultative support regarding reimbursement methodologies and policies • Discuss current and future reimbursement initiatives • Assist with ongoing educational presentations and serve as a senior training-team member • Review reimbursement opportunities using statistical reports, reimbursement summaries, and analytical procedures • Analyze coding practices and fee levels to determine impact • Plan reimbursement strategy • Prepare and present reports, recommendations, and advice to leadership • Create ad hoc reports showing estimated reimbursement impacts of policy and reimbursement-level changes • Assist in developing, reviewing, and revising reimbursement schedules • Develop code sets and payment methodologies supporting strategic growth initiatives • Lead and delegate review of new codes for appropriate fee-schedule additions and regulatory compliance • Serve as department liaison for researching and resolving coding, reimbursement, and health-plan policy issues across provider contracting • Assist with data development and planning needs • Draw conclusions from operational research and data analysis • Compile research into actionable conclusions • Provide pricing recommendations to various departments • Review designated provider claims to identify reimbursement opportunities and support recovery of inappropriately billed services • Analyze billed statistics, coding and charging practices, and industry information • Maintain knowledge of current reimbursement methodologies and provide technical resources • Develop and maintain detailed resource web pages for staff and departments • Update the master fee schedule with current and historical reimbursement rates for contracted providers and hospitals • Work in an office environment while complying with job-specific obligations and organizational policies

🎯 Exigences

• High School Diploma or Equivalent (GED) (Required) • Minimum of 8 years of relevant experience (Required), with relevant experience potentially combined with a degree obtained • Eastern Standard Time Zone resident • Communication skills • Multitasking skills • Teamwork skills • Ability to work independently • Proficiency and expertise in data applications and reporting tools • Ability to comply with contractual, state, and federal regulations • Ability to work 40 scheduled hours per week • Regular worker status • Exempt status

🏖️ Avantages

• Healthcare benefits for full-time and part-time positions from day one • Vision coverage • Dental coverage • Domestic partner benefits • Collaborative, cooperative, and collegial work atmosphere

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