Reimbursement Specialist (RS1) - PHMI New Jersey B.O. in Denville, NJ at Prime Healthcare

Date Posted: 4/17/2021

Job Snapshot

  • Employee Type:
  • Location:
    66 Ford Road
    Denville, NJ
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:

Job Description

Responsibilities Under the supervision of the Director of Reimbursement, a Reimbursement Specialist is responsible for accurate and timely payment analysis by comparing EOBs to contracted rates and determining if appropriate reimbursement is received from insurance companies. Ensure adjustments and write-offs are submitted regularly and appropriately investigated for accuracy before approval from Director.  Maintain a clear and concise understanding of the different adjustments and rationale for use. Proactively works with in-house resources to identify trends and resolve issues that hinder optimal and correct account payment that need to be escalated to insurance companies. Performs duties in accordance with Prime Healthcare values, policies, and procedures. Other duties as assigned to support the unit, department, entity, and health system.

Education and Work Experience:


1.    Experience with payment/EOB review.

2.    Medical billing and collection experience preferred.

3.    Knowledge of CPT, ICD-9, HCPCS coding structures.

4.    Medical and Insurance terminology essential.

5.    H.S. Diploma/GED required. Bachelor’s Degree preferred.


Preferred Skills:

AdaptabilityDetail orientedProblem solvingTeamwork

We are an Equal Opportunity/ Affirmative Action Employer and do not discriminate against applicants due to veteran status, disability, race, gender, gender identity, sexual orientation or other protected characteristics. If you need special accommodation for the application process, please contact Human Resources. EEO is the Law: