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| Job Role |
| Responsibilities: Ensures that the patients’ insurance covers treatment. Reviews appropriateness of CPT/ICD 9 coding and determines if care provided corresponds to the charges submitted. May assist in identifying fraudulent non-plan billing practices and assists in litigation preparations with legal department. |
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| Reimbursement Specialist |
| Instruction: Relies on instructions and pre-established guidelines to perform the functions of the job. Works under immediate supervision. Other wise relies on experience and judgment to plan and accomplish goals. Performs a variety of tasks. A certain degree of creativity and latitude is expected. Skills and Experience: Requires a bachelor’s degree in area of specialty and 0-4 years of experience in the field or in a related area. Has knowledge of commonly-used concepts, practices, and procedures within particular field. Supervision: Typically reports to a supervisor or manager. |
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