Provider Reimbursement Specialist

Job Summary

To support reimbursement methodologies and policies, the full-time remote Provider Reimbursement Specialist will research business rules, develop fee schedules, and perform quality analysis on claim submissions.

Key responsibilities

• Research and develop business rules for reimbursement methodologies and policies
• Develop and submit fee schedules to claim pricing platforms
• Perform quality analysis on claim submissions and provide correction instructions as needed

Required qualifications

• High School Diploma/GED
• 1+ years of experience in professional reimbursement research and analysis
• 1+ years of experience with CSP FACETs
• 6+ months of experience with provider contracts and interpretation of State requirements
• Intermediate to Advanced proficiency in Microsoft Excel and Word