Medical Reimbursement Specialist

Description:
Could you be our next Medical Reimbursement Specialist at HomeCare & Hospice?

Why work as a Medical Reimbursement Specialist with Main Line Health?

• Make an Impact! The Reimbursement Specialist, Utilization Review, is responsible for reviewing and interpreting clinical information in the medical record to submit authorization requests for home health clients with managed care insurance plans. This position requires attention to detail in order to request correct visit quantities, start dates and end dates per discipline needing authorization, according to each insurance plans guidelines for precertification. The Reimbursement Specialist communicates with clinicians (or the interdisciplinary team) as needed to obtain the additional clinical information required by insurance case managers. The Reimbursement Specialist must demonstrate excellent critical thinking and decision-making skills when reviewing documentation in the medical record and include appropriate clinical information on all authorization requests for the ongoing skilled care needed. The Reimbursement Specialist demonstrates dependability, efficiency and effectiveness in accordance with Main Line Health Home Care and Hospice policies and procedures.
  
  
• Develop and Grow your Career! Invest in furthering your education through seeking certifications or advanced degrees by taking advantage of our Tuition Reimbursement! This position is eligible for up to $6,000 per year based upon your Full or Part Time status.
  
  
• Join the Team! Like our patients, the Main Line Health Family encompasses a wide range of backgrounds and abilities. Just as each of our patients requires a personalized care plan, each of our employees, physicians, and volunteers, bring distinctive talents to Main Line Health. Regardless of our unique design, we all share a purpose: providing superior service and care.
  
  
• Position-Specific Benefits include: You are eligible for up to 120 hours of paid time off per year. We also offer a number of employee discounts to various activities, services, and vendors... And employee parking is always free!
  
  

Position: Sterile Processing Educator/Quality Coordinator
Shift: Day shift + every 4th weekend

Experience:
Minimum of two years related experience in a service oriented or health related organization required.
Experience in computers with knowledge of Microsoft Office, E-mail and Windows applications.
Keyboard skills of 40 to 45 WPM.
Must demonstrate excellent interpersonal, communication and organization skills.
Ability to read, write, speak, understand and communicate in English sufficiently to perform job duties required.
Working knowledge of home care and Medical Terminology preferred.
Working knowledge of managed care authorization procedures preferred.
Knowledge of HCPCS/CPT/ICD-10 and revenue codes preferred.

Education:
Minimum requirement: High School Graduation or Equivalent with additional training in computers.
Associates degree or higher preferred.

Licensures/Certifications:
N/A