How to Be Anesthetic Reimbursement Specialist - Job Description, Skills, and Interview Questions

The reimbursement of anesthesia services is a complex process that can be difficult for anesthesiologists to navigate alone. An Anesthetic Reimbursement Specialist can help anesthesiologists understand the financial and regulatory components of reimbursement, and ensure that their practice receives the correct payment for their services. By having an Anesthetic Reimbursement Specialist on staff, anesthesiologists can avoid costly reimbursement errors as well as ensure accuracy in their billing and coding.

This can lead to improved cash flow, better financial planning, and increased efficiency in their practice. it can help anesthesiologists to stay compliant with the rules and regulations of insurers and government agencies, such as Medicare and Medicaid.

Steps How to Become

1. Get a Bachelor's Degree. The first step to becoming an Anesthetic Reimbursement Specialist is to get a bachelor's degree in a related field such as accounting, finance, health administration, or business administration.
2. Get Certified. After obtaining a bachelor's degree, it is recommended that you become certified in Medical Reimbursement by the American Association of Professional Coders (AAPC). This is a recognized credential that demonstrates your knowledge and expertise in the area of medical reimbursement.
3. Gain Experience in Anesthesia Reimbursement. Once you have obtained certification, you should gain experience in anesthesia reimbursement. This can be done through internships or other job opportunities in the field.
4. Get Anesthesia Reimbursement Training. After gaining experience in anesthesia reimbursement, it is important to obtain additional training in this field. You can do this by taking courses through an accredited institution or attending seminars and workshops.
5. Take the National Certification Exam. After gaining the necessary training and experience, you can then take the National Certification Exam for Anesthetic Reimbursement Specialists (NCER). This exam is offered by the National Board of Medical Examiners (NBME).
6. Stay Current. As an Anesthetic Reimbursement Specialist, it is important to stay current with changes in the reimbursement field. You should take continuing education courses as well as attend seminars and workshops to stay up to date.

The lack of a reliable and capable anesthetic reimbursement specialist can have a serious impact on the overall financial health of a medical facility. Without an expert to handle the often complex issues related to insurance payments, claims may be rejected, resulting in lost revenue and increased administrative costs. A knowledgeable specialist can ensure that the claims are accurate and timely and can navigate the complex world of insurance regulations to ensure that the practice receives the maximum reimbursement for services rendered. In addition, employing a qualified reimbursement specialist can reduce the amount of time spent by medical staff dealing with administrative tasks, allowing them more time to focus on providing quality patient care.

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Job Description

1. Assist in the development of anesthesia fee schedules.
2. Research and analyze local, state, and federal laws and regulations regarding reimbursement policies.
3. Monitor and analyze changes in reimbursement policies, procedures and regulations.
4. Educate providers on coding and documentation requirements to ensure accurate reimbursement.
5. Collaborate with hospital, clinic and other practice administrators to ensure compliance with reimbursement policies.
6. Resolve or escalate complex billing issues regarding reimbursement for anesthesia services.
7. Develop and maintain effective relationships with third-party payers to maximize reimbursement for services rendered.
8. Prepare and submit claims to insurance companies and government agencies for payment of anesthesia services.
9. Review accounts receivables to ensure timely and accurate payment of services rendered.
10. Monitor payments received to ensure accuracy of reimbursement amounts.
11. Analyze trends in reimbursement payments and recommend strategies to improve collections.
12. Prepare reports on reimbursement activity for management review.
13. Perform other duties as assigned.

Skills and Competencies to Have

1. Knowledge of billing, coding and reimbursement rules for anesthetic services
2. Familiarity with medical terminology
3. Ability to interpret and apply payer policies and regulations
4. Strong organizational, communication and problem solving skills
5. Proficiency in computer applications such as Microsoft Office
6. Knowledge of insurance company claims processing systems
7. Detail-oriented with the ability to multi-task and prioritize
8. Ability to interact effectively with providers, staff and patients
9. Ability to work independently and in a team environment
10. Ability to research and resolve complex reimbursement issues

Anesthetic Reimbursement Specialists are responsible for ensuring that health care providers are reimbursed for their services in an efficient and timely manner. To succeed in this role, an Anesthetic Reimbursement Specialist must have excellent communication, problem solving, and organizational skills. They must be able to understand complex medical codes and regulations, and be able to accurately process electronic claims.

It is also essential that they have the ability to multitask and stay organized in a fast-paced environment. they must be proficient in using medical billing software and have the ability to quickly learn new systems. Without these essential skills, Anesthetic Reimbursement Specialists may be unable to effectively process claims and could potentially leave health care providers out of pocket.

Therefore, having these key skills is essential for succeeding in this role.

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Frequent Interview Questions

• What experience do you have with anesthetic reimbursement?
• How have you handled difficult reimbursement claims in the past?
• What strategies do you use to ensure accurate and timely payments for anesthetic services?
• What techniques do you use to identify and address coding errors?
• What processes do you use to monitor and audit claims?
• How familiar are you with the various insurance regulations and policies related to anesthetic reimbursement?
• What challenges have you encountered in the past when dealing with anesthetic reimbursement?
• How do you stay current on changes in the healthcare industry that might impact anesthetic reimbursement?
• What strategies do you use to manage competing priorities when dealing with anesthetic reimbursement?
• What do you think makes a successful reimbursement specialist?

Common Tools in Industry

1. Electronic Medical Records System (EMR). A comprehensive software system that stores and tracks patient medical records and information. (eg: Epic, Cerner, etc. )
2. Billing Software. Software that helps process and manage insurance claims and payments. (eg: Kareo, AthenaHealth, etc. )
3. Practice Management System. A system that helps streamline administrative tasks such as scheduling appointments, tracking patient data, billing, and reporting. (eg: AllScripts, Greenway, etc. )
4. Coding Software. Software that helps translate medical terms into codes used to submit insurance claims and manage reimbursement. (eg: Optum360, EncoderPro, etc. )
5. Reimbursement Software. Software that helps manage the reimbursement process by creating and tracking claims, resolving disputes, and managing payments. (eg: ClaimRemedi, MediRevv, etc. )

Professional Organizations to Know

1. American Society of Anesthesiologists (ASA)
2. American Association of Nurse Anesthetists (AANA)
3. American Medical Billers Association (AMBA)
4. Healthcare Financial Management Association (HFMA)
5. National Association of Healthcare Reimbursement Professionals (NAHRP)
6. National Council for Prescription Drug Programs (NCPDP)
7. American Academy of Professional Coders (AAPC)
8. National Society of Professional Coders (NSPC)
9. American Association of Medical Auditors (AAMA)
10. Health Care Compliance Association (HCCA)

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Common Important Terms

1. Coding. The process of assigning a code to a medical procedure or diagnosis in order to determine the amount of reimbursement a provider will receive.
2. Fee Schedule. A listing of services and procedures that are eligible for reimbursement and the associated fee associated with each service.
3. Medicare. The federal health insurance program for people aged 65 and older or people with certain disabilities.
4. Medicaid. A program jointly funded by the federal government and state governments that provides health care services for people with limited incomes.
5. Claims Processing. The administrative process of verifying, adjudicating, and paying health care claims submitted by providers or patients.
6. Denial Management. The process of understanding the reasons a claim was denied and taking corrective action to ensure that the claim is paid correctly.
7. Medical Necessity. The determination of whether a medical service is medically necessary and appropriate for an individual’s condition.
8. ICD-10. The International Classification of Diseases, 10th Revision, which is used to classify diseases and other health problems.

Frequently Asked Questions

What is an Anesthetic Reimbursement Specialist?

An Anesthetic Reimbursement Specialist is a healthcare professional who specializes in the reimbursement and billing of services related to anesthesiology. They ensure that anesthesiology services are properly billed and paid for by insurance providers and other third-party payers.

What qualifications are required to become an Anesthetic Reimbursement Specialist?

An Anesthetic Reimbursement Specialist must possess a minimum of a high school diploma, although many employers prefer applicants with a college degree. Additionally, a certification as a Certified Professional Coder (CPC) or Certified Coding Specialist (CCS) is usually required.

What types of duties does an Anesthetic Reimbursement Specialist perform?

An Anesthetic Reimbursement Specialist is responsible for the accurate billing and reimbursement of anesthesiology services. This includes preparing and submitting claims to insurance companies and other payers, verifying accuracy of submitted claims, and researching and resolving any discrepancies in payments.

What type of salary does an Anesthetic Reimbursement Specialist make?

According to the Bureau of Labor Statistics, the median annual wage for an Anesthetic Reimbursement Specialist is $47,490 per year as of May 2020.

What are the job prospects for an Anesthetic Reimbursement Specialist?

The job outlook for Anesthetic Reimbursement Specialists is expected to grow by 10% between 2018 and 2028, faster than the average rate of growth for all occupations.

What are jobs related with Anesthetic Reimbursement Specialist?

• Anesthetic Claims Processor
• Anesthetic Account Manager
• Anesthetic Regulatory Affairs Specialist
• Anesthetic Informatics Nurse
• Anesthetic Project Manager
• Anesthetic Medical Coder/Biller
• Anesthetic Safety Officer
• Anesthetic Regulatory Compliance Officer
• Anesthetic Data Analyst
• Anesthetic Supply Chain Manager

Web Resources

• Reimbursement Specialist 11554 | Expires: 2022-07-15 www.ptc.edu
• Anesthesia - Harvard University www.cha.harvard.edu
• Health Information & Reimbursement Specialist • Northwestern ... www.nwcc.edu