Network Reimbursement Specialist

Job-Specific Requirements

• Bachelor’s degree required.
• Logical thought process in order to interpret and apply contract benefits.
• Ability to work with a high degree of accuracy and attention to detail to ensure work products are of high quality.
• Good analytical skills and proven ability to independently research, document and present solutions to problems.
• Strong documentation and organizational skills required.
• Strong interpersonal, communication and facilitation skills required.
• Ability to multi-task and handle concurrent projects.
• Knowledge of Microsoft Excel and Word is required.

Responsibilities

• Implement, coordinate and maintain all routine provider reimbursement updates, including updates to professional and allied fee schedules, updates to facility reimbursement rates, pricing rule changes.
• Develop, execute and complete test plans and related claims testing when implementing new or modifying existing reimbursement functionality.
• Serve as the subject matter expert in Network reimbursement as it pertains to the functionality within the medical claims processing system.
• Act as a technical consultant for medical claim reimbursement related inquiries received from other departments or external sources.

Qualifications

Blue Cross & Blue Shield of Mississippi is an Equal opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We offer a comprehensive benefits package that is worth approximately one-third of the salary compensation. Our benefits program is among the best in the health care field.