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Job SummaryThis position is responsible for translating contractual language/provisions into configurable reimbursement terms in the Enterprise Discounting application for Commercial lines of business (current and future) to ensure Blue Cross of Illinois network facilities receive accurate and timely contractual payments and allowances (i.e. discounts). Also responsible for auditing, claim testing, generating and validating monthly ad-hoc reports for both internal and external customers.Required Job Qualifications:
* Bachelor Degree in Finance, Accounting, Math or Health Care and 2 years managed care / financial analysis experience, OR 6 years managed care / financial analysis experience.
* Verbal and written communication skills.
PC proficiency inclusive of spreadsheet/database software including Excel and Access.
Preferred Job Qualifications:
* Experience with software language such as SQL, SAS and SPSS.* Knowledge of hospital and institutional provider billing, payment methodologies, and managed care contracts.
* Experience working for a Managed Care Organization in Provider Data Operations, Network Management Contracting, or Provider Relations to include knowledge of business processes that impact facility/ancillary contract loading and auditing or 4 years pricing configuration experience with ancillary and hospital contracts (Medicare or Commercial plans) including claims testing and auditing
*This is a hybrid role requiring 3 days in the office and 2 days remote weekly.
We encourage people of all backgrounds and experiences to apply.Even if you don't think you are a perfect fit, apply anyway - you might have qualifications we haven't even thought of yet.
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HCSC Employment Statement:HCSC is committed to diversity in the workplace and to providing equal opportunity and affirmative action to employees and applicants. We are an Equal Opportunity Employment / Affirmative Action employer dedicated to workforce diversity and a drug-free and smoke-free workplace. Drug screening and background investigation are required, as allowed by law. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status.
Full Time
Business Services
$47k-57k (estimate)
03/21/2024
05/08/2024
healthcareservicesgroup.com
BENSALEM, PA
100 - 200
Private
$10M - $50M
Business Services
The job skills required for Reimbursement Specialist include Billing, Accounting, Health Care, Managed Care, Futures, Written Communication, etc. Having related job skills and expertise will give you an advantage when applying to be a Reimbursement Specialist. That makes you unique and can impact how much salary you can get paid. Below are job openings related to skills required by Reimbursement Specialist. Select any job title you are interested in and start to search job requirements.
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Step 1: Understand the job description and responsibilities of an Accountant.
Quotes from people on Reimbursement Specialist job description and responsibilities
Reimbursement specialists utilize reference materials and medical coding knowledge to address claims.
04/22/2022: Frankfort, KY
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Career tips from people on Reimbursement Specialist jobs
The career path for a reimbursement specialist starts by first obtaining a high school diploma or GED.
05/26/2022: Boca Raton, FL
Educational prerequisites for reimbursement specialists vary, from a minimum of a high school diploma to a bachelor’s degree.
04/27/2022: New York, NY
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