RN Clinical Reimbursement Specialist

Sweetwater Care; Melrose (MA); On-site; USD 70,000 - 95,000; Full time

Job summary

Sweetwater Care in Melrose, MA is seeking an RN Clinical Reimbursement Specialist to ensure accurate and timely reimbursement for patient care services.

Responsibilities include reviewing medical records, coding with ICD-10 and CPT, denying management, and collaborating with cross-functional teams.

Requirements: MA RN license, 2+ years in clinical reimbursement, strong analytical and communication skills, and ability to work in a fast-paced environment. Salary and benefits discussed at interview.

Qualifications

• 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

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

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

• 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

Note: Salary and benefits information will be discussed during the interview process.