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Health Services WellCare - Clinical Support Careers

Clinical Reimbursement Specialist Job

Full Job Title: Clinical Reimbursement Specialist

Job Number: 1704784

Location: Tampa, FL

Date Posted: 10-20-2017

Department: Health Services
Reports to: Sr. Dir. Strategic Initiatives
Location: Tampa, FL

Job description

  • Facilitates clinical documentation improvement through the identification of documentation issues impacting revenue, severity and quality.
  • Has extensive day to day interaction with physicians, nurse practitioners, physician assistants, residents and other patient care givers regarding documentation.
  • Ensures the quality of documentation in the patient medical record to enhance quality of care, support accurate data reporting to regulatory agencies, and appropriate reimbursement.
  • Reports diagnoses and complications when appropriate.
  • Maintains knowledge of current regulatory and coding guidelines.
  • Responsible for performing job duties in accordance with mission, vision and values of the facility
Education/Experience:
  • BA/BS Degree
  • Experience with Medicaid and Medicare.

  • Knowledge of DRG Coding

  • Knowledge of ICD-9

Computer Skills:
  • Solid knowledge of Microsoft Office including Outlook, Access, Excel and Word

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Last Updated On: 12/9/2015