Job Description
Job Description
RN Clinical Reimbursement Specialist
Join the Sweetwater Care team in Melrose, MA, as we seek a dedicated and detail-oriented RN Clinical Reimbursement Specialist to play a vital role in our organization's mission.
As a RN Clinical Reimbursement Specialist, you will be responsible for ensuring accurate and timely reimbursement of patient care services. This is a full-time opportunity that requires strong clinical knowledge, excellent analytical skills, and the ability to collaborate with cross-functional teams.
Responsibilities:
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Clinical Reimbursement: Conduct thorough reviews of medical records, patient information, and billing data to ensure accurate reimbursement of services provided
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Coding and Billing: Utilize ICD-10 and CPT coding systems to prepare accurate and complete claims for submission to payors
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Denial Management: Identify and resolve denied claims in a timely and efficient manner to minimize revenue loss
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Compliance: Stay up-to-date with changing regulations and guidelines to ensure compliance with reimbursement policies and procedures
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Data Analysis: Analyze and interpret data to identify trends and areas for improvement in reimbursement processes
Requirements:
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Current RN licensure in the state of Massachusetts
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Minimum 2 years of experience in clinical reimbursement or a related field
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Strong analytical and problem-solving skills
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Excellent communication and collaboration skills
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Ability to work in a fast-paced environment with multiple priorities
What We Offer:
If you are a motivated and detail-oriented RN with a passion for reimbursement and a desire to join a dynamic team, please consider applying for this exciting opportunity.
To apply, please submit your application.
Note: Salary and benefits information will be discussed during the interview process.