Job Description

Full Time

Monday - Friday

8:00 a.m. to 4:30 p.m.

Job Summary

The Reimbursement Specialist is responsible for accurate and timely billing, coding support, and reimbursement processes for hospital and clinic services in a Critical Access Hospital setting. This role ensures claims are submitted in compliance with federal, state, and payer regulations while maximizing appropriate reimbursement and minimizing denials. The Reimbursement Specialist works closely with clinical departments, patient access, and payers to resolve billing issues, follow up on claims, and support the financial health of the organization. This is a full-time position requiring strong attention to detail, knowledge of healthcare billing regulations, and a commitment to patient-centered service.

Requirements

Education

+ High School Diploma or GED equivalent required.
+ Associate or Bachelor Degree in Business or Accounting preferred.

Licenses, Certifications, or Registrations

+ Valid Driver's License, required

Experience

+ Working knowledge of medical billing practices, including Medicare, Medicaid, and commercial payers
+ Familiarity with CPT, HCPCS, and ICD-10 coding principles
+ Experience with claim submission, payment posting, denial management, and account follow-up
+ Understanding of Critical Access Hospital reimbursement methodologies preferred
+ Proficiency with electronic health records (EHR) and billing software systems
+ Strong attention to detail and ability to maintain accuracy in a fast-paced environment
+ Ability to interpret payer contracts, explanation of benefits (EOBs), and reimbursement guidelines
+ Effective communication skills for working with patients, payers, and internal departments
+ Ability to prioritize tasks, meet deadlines, and work independently with minimal supervision
+ Knowledge of HIPAA and patient confidentiality requirements
Language Skills + Must be capable of communicating clearly (reading, writing, and speaking) in the English Language. Must be capable of reading and comprehending written policies/procedures and operation/maintenance instructions. Must have the ability to receive and relay phone or other business messages.
Equipment + Must be able to operate computer, telephone and other department specific equipment required to perform duties of position.

Benefits

We offer a complete, comprehensive benefit package that includes:Health Dental Vision Life Retirement Savings with Employer Match Health Savings Accounts, with Employer Match Flexible Spending Accounts, Medical & Dependent Care Supplemental Coverages including Short Term & Long Term Disability, Accident, Hospital Confinement, Cancer Paid Time Off Employee Assistance Program * And most importantly, we offer a flexible work environment that supports a healthy work-home life balance.