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Reimburs Appeals Sr Associate

Nebraska Medicine Omaha, NE

Job Description

Provide expertise in routine third party reimbursement. Optimizes hospital revenue by researching, auditing, identifying trends and resolving possible claim denials through a standardized appeal process. Analyzes payments and payment accuracy comparing billed charges to payment and expected reimbursement for commercial, invoice and governmental payers.

Required Qualifications:

  •  Minimum of three years experience with hospital or physician revenue cycle processes required.
  • High school education or equivalent required.
  • Knowledge of hospital and/or professional revenue cycle processes required.
  • Ability to work with diverse customer base through effective verbal and written communication required.
  • Multi-tasking and problem solving abilities required.
  • Knowledge of computer based programs including Microsoft Word and Excel required.
  • Strong verbal and written communication skills required.
  • Strong organizational skills with aptitude for detail oriented work required.
  • Ability to type a minimum of 45 words per minute with 95% accuracy required.
  • Knowledge of medical terminology, international classification of diseases (ICD), current procedural terminology (CPT) and healthcare common procedure coding system (HCPCS) required.
  • Knowledge of correct coding initiative (CCI)/outpatient code editor (OCE)/national coverage determination (NCD)/ local coverage determination (LCD) edits required.
  • Knowledge of governmental reimbursement rules and regulations preferred.
  • Knowledge of ambulatory payment classifications (APC), diagnosis related group (DRG), and fee-for-service (FFS) reimbursement methodologies preferred.
  • Knowledge of third party payer edits preferred.
  • Certification through hospital or professional revenue cycle organization preferred.
  • Membership in hospital or professional revenue cycle organization preferred.

Preferred Qualifications:

  • Prior experience with both hospital and physician revenue cycle.
  • Associates degree in business administration of college level business course work preferred.
  • Knowledge of databases and flowcharting processes preferred.





Job Details

Date Posted April 24, 2019
Date Closes May 9, 2019
Requisition 14948
Located In Omaha, NE
Work At Nebraska Medical Center
SOC Category 00-0000.00