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Reimbursement Specialist

Job ID REIM3704 Date posted 07/12/2017 Department REIMBURSEMENT-C53 Home Department Reimbursement-NP-Floral-SS7C53001

Discover a whole new healthcare management experience when you join Summit Health Management, where our clients receive a complete package of services geared towards strengthening physician practice management, including organizational structure and governance, operations, revenue, physician management and population health management. Here, you will discover a one-stop career destination with an interdisciplinary team environment and endless ways to grow your expertise.

As an integral member of our team and reporting to the Reimbursement Supervisor, you will help our clients that include Summit Medical Group and other mid-to-large size physician practices, drive performance enhancement across their practice.

Responsibilities include:

  • Daily review and follow up on all incomplete electronic provider billing encounters,
  • Ability to identify issues, correct, code and/or pend due to missing information
  • Apply in depth knowledge of coding principles to validate missing or incomplete CPT, HCPCS, or IDC-10 codes
  • Appropriate assignment of diagnosis codes to CPT codes
  • Ability to code Surgical Procedures including but not limited to Orthopedics, Neurosurgery, Podiatry, and Urology - a plus.
  • Review and completion of claim edits
  • Review of Denials including writing appeals and facilitating their submission
  • Ability to run standard reconciliation reports
  • Handling other reimbursement related functions as assigned


To qualify, you must have a HS Diploma/GED (AAS or BS preferred), 5-8 years' experience that includes familiarity with CPT and ICD-10 resources. Knowledge of revenue cycle applications, Medical Terminology, Human Anatomy and Physiology and Disease Processes. AAPC or AHIMA certification preferred. Superior analytical, planning, problem solving, organizational, oral/written communication, and PC (Word/Excel) skills are all essential.



About Us

Emerging from the success of SMG, SHM offers an entrepreneurial model of management services to physician practices across the United States. We help our clients drive performance enhancement across their practice and enable them to achieve clinical, financial and operational success.