**FIND YOUR FUTURE** We're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration. **Overview** The Network Reimbursement Specialist-Associate will ensure that all policies and processes that support physician, provider and ancillary agreements are adhered to and applied with a high degree of accuracy in workflows. The Network Reimbursement Specialist-Associate will have an understanding of industry and/or regulatory coding standards related to reimbursement methodology, billing practices, and coding rules and continue to build that knowledge while in this role. The primary responsibility of the Network Reimbursement Specialist-Associate will include independent determinations on manual claim procedures based on departmental standard operating procedures. They will also assist in the maintenance of additional supportive workflows on the team as directed by management. The Network Reimbursement Specialist-Associate will support claim processing via Network Reimbursement claim queues as directed. The incumbent will also be required to actively participate in work groups or teams to implement processes or provide information to management to assist in corporate objectives as they relate to professional reimbursement. **Qualifications** + High school diploma or GED required. Associates degree preferred. + One (1) year of healthcare experience in claims, billing and/or reimbursement required. + Understanding of industry standard claims edits and correct coding requirements required. + Current certification of Certified Professional Coder, American Academy of Professional Coders or will be required to obtain certification within (1) one year required. + Strong working knowledge of CPT, ICD-9-CM, ICD-10-CM and HCPCS coding systems. + Strong analytical skills. + Ability to assume responsibility and accomplish daily tasks with little to no direct oversight. + Effective written and verbal communication skills. + Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable. **Essential Accountabilities** + Assist in the timely review and manual adjudication of professional claims through claim queues; meeting agreed upon key performance indicators for output with a high degree of accuracy. + Assist in the timely review of weekly, monthly, and/or quarterly claim reports to support network reimbursement workflows. + Understand Independent Health reimbursement policies and standard operating procedures and independently apply that to manual claim adjudication. + As directed, assist with the triage and maintenance of the professional fee request process. + Assist in updating the corporate Participating Provider Reimbursement Manual. + Assist in the maintenance of team meeting agendas and minutes as well as manage workflow volumes and turnaround times for the team. + As directed, actively contribute to or participate on team meetings and discussions as well as collaborate with other team members on assigned projects. + Assist in the establishment of standard operating procedures consistent with correct coding and billing guidelines or as defined by Independent Health policy. + As directed, assist Network Reimbursement Professionals and Management with matters of professional reimbursement or process implementation. + Assist in the tracking and maintenance of reimbursement policies. + Establish process to continue to grow knowledge of industry standards related to reimbursement methodologies, billing practices and coding rules. **_Immigration or work visa sponsorship will not be provided for this position_** Hiring Compensation Range: $20.00 - $22.00 hourly _Compensation may vary based on factors including but not limited to skills, education, location and experience._ In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future. _As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law._ _Click here (http://www.independenthealth.com/about/careers/additional-eeo-aap-information)_ _for additional EEO/AAP_ _or Reasonable Accommodation_ _information._ Current Associates must apply internally via the Job Hub app. The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well-being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation. Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you’re part of something special, in your work and in the community. We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog. We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more. Please click here (http://www.independenthealth.com/about/community-report) to view our Community Reports. **Apply today and join us on the journey to a happier, healthier, and more inclusive community.** We are a drug-free workplace. We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: accommodations@independenthealth.com or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221. _Please note, we do not accept unsolicited resumes. We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us._