• Novant Health
  • $62,560.00 -82,140.00/year*
  • Washington, NC
  • Healthcare - Nursing
  • Full-Time
  • 4247 Cherry Rd

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Novant Health is seeking a Reimbursement Specialist RN to manage the maximization of reimbursement for clinical services through the identification of appropriate care settings, resource and supply utilization and contractual variances between posted and expected reimbursement for managed care, government contracts, and all other payors. This responsibility encompasses contractual reimbursement analysis and communication of variances to clinical departments. They will work directly with operational finance, charge description master team, patient accounting and designated clinical departments to assess and educate clinical departments on charge capture and resource utilization in relation to reimbursement. They will be responsible for assisting with the identification and education of underpayment/overpayments, denials, revenue opportunities and revenue leakage. Will work with respective departments to evaluate trends, and be part of the team that works towards resolution and improvement of revenue cycle processes within the designated clinical area. Responsible for conducting quality control audits to ensure data/documentation integrity, and communicating findings and recommendations, explaining regulatory requirements, and overseeing the corrective actions for audits within the operational units. Compile reports and analyses and performs subsequent audits to ensure complete and appropriate corrective action. Will work with clinicians on contract interpretation, and ensuring the distribution of correspondence from Business Office reaches. #JoinTeamAubergine #NovantHealth. Let Novant Health be the destination for your professional growth.


Qualifications:

  • Education: Bachelor's degree required. Master's degree preferred. BSN or nursing related field required.
  • Experience:Minimum of three years of relevant experience in clinical healthcare environment required. Revenue Cycle Experience one to five years, auditing, coding preferred.
  • Licensure/Certification/Registration:Current RN licensure in appropriate state required. RHIA, RHIT preferred.
  • Additional skills required:Knowledge, skills and abilities required: Ability to communicate effectively with both technical and operational stakeholders at all levels line-level Staff to management / leadership aligning understanding across levels and disciplines (technical/functional/clinical). Ability to identify, summarize, communicate trends with proposed solutions to identified findings. Ability to analyze data and report findings to groups and individuals in a constructive and solution oriented manner. Working knowledge of Revenue Cycle regulatory and governing standards, policies and procedures. Knowledge of CPT, HCPCS, DRG, reimbursement methodologies, and revenue codes. General knowledge of revenue cycle processes. Excellent communication and organizational skills required.
  • Additional skills preferred:EPIC experience.


  • It is the responsibility of every Novant Health team member to deliver the most remarkable patient experience in every dimension, every time.
  • Our team members are part of an environment that fosters team work, team member engagement and community involvement.
  • The successful team member has a commitment to leveraging diversity and inclusion in support of quality care.
  • All Novant Health team members are responsible for fostering a safe patient environment driven by the principles of \"First Do No Harm\".


Associated topics: asn, cardiothoracic, domiciliary, infusion, intensive care, maternal, nurse, surgical, tcu, transitional

* The salary listed in the header is an estimate based on salary data for similar jobs in the same area. Salary or compensation data found in the job description is accurate.

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