Reimbursement Specialist in Knoxville, TN for East Tennessee Children's Hospital

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Reimbursement Specialist

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Knoxville, Tennessee

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Reimbursement Specialist

East Tennessee Children's Hospital

Details

Posted: 07-Jan-22

Location: Knoxville, Tennessee

Salary: Open

Categories:

Allied Health

Internal Number: 9460

BASIC PURPOSE OF THE JOB
- Responsible in reviewing accounts to ensure payments from contracted payers are correct. Responsible for collection of payment variances. Works with collectors on issues with line item denials and appeals accounts as needed. Back up for lead in daily duties when they are out with things such as: Inquires from other departments to explain contractual, expected payments etc. Comfortable with how contracts are loaded and how the process works to assist team leader when changes are needed.
JOB REQUIREMENTS
- Minimum Education
  - High School Diploma/GED preferred
- Minimum Work Experience
  - Hospital billing and collected experience preferred.
  - Hospital or insurance contract experience preferred.
- Required Licenses/Certifications for position
  - No
- Required Skills, Knowledge, and Abilities
  - Excellent customer service skills and ability to work well with a team required.
  - Familiar with rules and regulations of CMS and other third party payers to ensure proper set up of contract and can work with billing staff to ensure clean claims on first time submission.
  - Ability to work with insurance companies to ensure timely payment of claims and address payment variances.
  - Work with Contract team at time of contract renewals to address contract compliance issues.
  - Able to problem solve.
PHYSICAL REQUIREMENTS
- Note: Reasonable accommodations may be made for individuals with disabilities to perform the essential functions of this position.
- Light lifting, pushing and pulling is required for 10-20 lbs occasionally and frequent moving of objects of less than 10 lbs is required. Frequent sitting with some walking, standing, squatting, bending and reaching is required. Keyboard/computer use and/or repetitive motions may be required.

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About East Tennessee Children's Hospital

East Tennessee Children's Hospital is a 152-bed hospital certified by the state of Tennessee as the only Comprehensive Regional Pediatric Center in East Tennessee and is accredited by the Joint Commission. As a Comprehensive Regional Pediatric Center, Children's Hospital offers full capabilities to care for seriously ill children in a unique pediatric environment and offers the services of many different pediatric subspecialties. Children's Hospital works jointly with the University of Tennessee Medical Center to ensure that injured children in this region receive trauma care at the institution most appropriate for the child's needs. We also assist smaller hospitals by providing pediatric health care training opportunities.

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