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:

Clinical Reimbursement:

Conduct thorough reviews of medical records, patient information, and billing data to ensure accurate reimbursement of services provided

Coding and Billing:

Utilize ICD-10 and CPT coding systems to prepare accurate and complete claims for submission to payors

Denial Management:

Identify and resolve denied claims in a timely and efficient manner to minimize revenue loss

Compliance:

Stay up-to-date with changing regulations and guidelines to ensure compliance with reimbursement policies and procedures

Data Analysis:

Analyze and interpret data to identify trends and areas for improvement in reimbursement processes

Requirements:

Current RN licensure in the state of Massachusetts Minimum 2 years of experience in clinical reimbursement or a related field Strong analytical and problem-solving skills Excellent communication and collaboration skills 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.