Reimbursement Specialist II
Sarasota Memorial Health Care System
Sarasota, Florida
Provides administrative support responsible for accurate and timely posting of Surgery, Emergency Room (ECC) charges for either SMHCS or North Port, hospital wide observation charges, or Delivery/High Risk Antepartum/Testing/Triage charges, under the direction and supervision of Revenue Cycle Management. Provides compliant charging practices for all payors by reviewing the medical record for appropriate clinical documentation that supports the accuracy of charges. Independently resolves Surgery, Emergency Room, Observation, or Delivery/ High Risk Antepartum/Testing/Triage charge Correct Coding Initiative (CCI) edits. Performs other reimbursement assignments to resolve billing, coding, or collection issues. Interacts with clinical staff to educate and improve clinical documentation that supports the accuracy of care provided and charges posted. Assists Revenue Cycle staff in providing information to support appeals or audits. Acts as a leader, mentor, and trainer to other Reimbursement Specialists.
Required Qualifications:- Require a minimum of four (4) years of health care experience involving charging practices and patient flow processes.
- Require coding certification.
- Prefer clinical certification from a recognized health care credentialing organization in a specialty area (i.e. RRA, RT, VI, CI, RCIS, RVS, SCFA and CST).
- Prefer demonstrated interpersonal and communication skills.
- Prefer working knowledge of commonly used computer applications.
- Prefer the ability to work with minimal supervision.
- Prefer demonstrated proficiency with medical terminology.
- Prefer demonstrated proficiency with specific charging and coding as it applies to various departments (i.e. Surgery, Emergency Room, Observation, or Delivery/High Risk Antepartum/Testing/Triage).
HS EQ: High School Diploma, GED or Certificate
Work Days/Shift/Start Time:Reputation. Community. Impact. Growth.
Every day, our patients at Sarasota Memorial Health Care System receive a first-class experience in care from a team on a mission to deliver the highest level of care in America. In the process of rising to that challenge, one by one, our people are finding their purpose and feeling their impact. Now it is your turn to see yourself here.
Recognition:
* 5- Star Quality Rating- SMH- Sarasota is the only hospital in Florida to earn the federal Centers for Medicare & Medicaid Services' highest rating every year since its inception.
* 50 Best Hospitals- SMH ranked among U.S. News & World Report's 50 Best Hospitals in two specialties, Rehabilitation and Obstetrics/Gynecology in 2023-2024, and among the nation's top 10% high peformers in 18 other medical specialties, procedures and conditions.
* World's Best Hospitals- SMH- Sarasota has made Newsweek's prestigous list six years in a row, since the global rankings began in 2019.
* "A" for Patient Safety- SMH- Sarasota has earned straight A's since it began participating in the Leapfrog Group's hospital safety survey in 2016.
* Magnet Hospital- SMH has been recognized as a Magnet hospital for the past 20 years by the American Nurses Credentialing Center, a continuous achievement for nursing excellence shared by less than 1% of hospitals nationwide.
* America's Best Employer/Workplace- SMH topped Forbe's list of America's Best Employers, ranking among the top 20% of large employers across all industries in 2024, and #1 healthcare employer in Florida in 2023. The health system also earned a 5-star rating in Newsweek's 2024 list of "America's Greatest Workplaces for Women."
The benefits of being the best:
Our commitment to becoming the best community hospital and health care system means providing the best possible benefits to our people. Some highlights:
Total Rewards Package
- Paid Time Off (start earning PTO on day one of employment)
- Tuition Reimbursement
- Discounted Medical, Prescription, Dental, Vision Benefit Plans for Full & Part-Time Employees
- Flexible Spending Accounts (Health Care and Dependent Care) - Pre-Tax Dollars
- Life Insurance
- Competitie rates
- Bonuses offered
- Disability Insurance
- Retirement Savings Plan: 403b
- Sarasota Campus for now - Discounted Child Care & Before and After School Program and Summer Camp!
- Bereavement Leave
- Free Parking
- On Campus Dining w/ a 10% discount
- Credit Union w/ teller machines on campus
- Direct Deposit
- Free Wellness Screening
- Free confidential counseling services
- Employee Discount Programs
- Recognition Programs
- Referral Programs
- Tremendous growth opportunities for hard workers!