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.

• 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

• 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

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.