Reimbursement Specialist

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    "ExternalDescriptionStr": "<p><strong>Job: Reimbursement Specialist</strong></p><p><strong>Schedule: PRN (ONLY AS NEEDED)</strong></p><p>&nbsp;</p><p><strong>Your experience matters&nbsp;</strong></p><p>Community Medical Center is operated jointly with Lifepoint Health. We are driven by a profound commitment to prioritize your well-being so you can provide exceptional care to others. As a Supply Chain Technician joining our team, you’re embracing our promise to provide superior patient care that exceeds industry standards as well as patient expectations. Join us on this meaningful journey where your skills, compassion and dedication will make a remarkable difference in the lives of those we serve.</p><p><strong>Job Summary:</strong><br>An Reimbursement Speicalist is responsible for ensuring that all oncology-related services, procedures, and treatments are properly authorized or pre-certified before they are rendered, in compliance with insurance and payer requirements.</p><p><strong>How you'll contribute:&nbsp;</strong><br>A Reimbursement specialist who excels at this role:&nbsp;</p><ul><li class=\"ortl-align-justify\"><p style=\"margin-left: 0px; text-align: justify;\">Verify that oncology services meet pre-certification or pre-authorization requirements before treatment begins.</p></li><li class=\"ortl-align-justify\"><p style=\"margin-left: 0px; text-align: justify;\">Confirm patient insurance eligibility and benefits, ensuring coverage for scheduled oncology procedures and/or medications, radiology imaging and surgeries.</p></li><li class=\"ortl-align-justify\"><p style=\"margin-left: 0px; text-align: justify;\">Complete and submit accurate third-party payer authorization requests, including gathering and verifying CPT codes, diagnosis codes, and other required data elements.</p></li><li class=\"ortl-align-justify\"><p style=\"margin-left: 0px; text-align: justify;\">Communicate with oncology physicians, nurse practitioners, and ancillary departments to obtain necessary documentation and physician orders.</p></li><li class=\"ortl-align-justify\"><p style=\"margin-left: 0px; text-align: justify;\">Record authorization approvals or denials in the electronic health record (EHR) and ensure all required signatures are obtained for treatments.</p></li><li class=\"ortl-align-justify\"><p style=\"margin-left: 0px; text-align: justify;\">Provide clear information to patients about authorization status, costs, and any required pre-payments.</p></li></ul><p>&nbsp;</p><p><strong>What we are looking for:&nbsp;</strong></p><ul><li><p style=\"margin-left: 0px;\"><strong>Education:</strong> High school diploma or equivalent required; preferred post-secondary courses in medical terminology, diagnosis, CPT coding, anatomy &amp; physiology; or a medical assistant, health unit coordinator, or healthcare business service program.</p></li><li><p style=\"margin-left: 0px;\"><strong>Experience:</strong> Minimum 2 years in a medical business office or healthcare setting with patient-facing responsibilities; prior authorization experience preferred.</p></li></ul><p>&nbsp;</p><p><strong>Why join us:</strong></p><p>We believe that investing in our employees is the first step to providing excellent patient care. In addition to your base compensation, this position also offers:</p><ul><li>Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees.</li><li>Financial Protection &amp; PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.</li><li>Financial &amp; Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.</li><li>Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).</li><li>Professional Development: Ongoing learning and career advancement opportunities.</li></ul><p>&nbsp;</p><p><strong>EEOC Statement:</strong></p><p>Community Medical Center is an Equal Opportunity Employer. &nbsp;Community Medical Center is committed to Equal Employment Opportunity for all applicants and employees and complies with all applicable laws prohibiting discrimination and harassment in employment.”</p>",
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