Reimbursement Specialist Contract Compliance Job at Intermountain Healthcare
Intermountain Healthcare Broomfield, CO
Job Description:
No Summary AvailablePractice Details:
This is a remote position.
We have multiple schedule options ( standard, flex, or 4 10 hr shifts M-F generally starting at 6am.
As a Reimbursement Specialist you need to know how to:
Evaluate payment variances in Epic WQs against payer contracts to determine if payer underpaid or overpaid, and dispositions variance based upon established protocols.
Identify trends through reporting and data analysis and leverages data to resolve errors in Epic proration rules, payer under and/or overpayment trends, opportunities in billing, and opportunities with managed care contracting efforts.
Log findings and provides feedback to Hospital Billing
AR Management, Cash Management, and Managed Care leadership.
Perform root cause analysis and recommends and develops process improvement.
Serve as a liaison to internal teams to include the Epic Contract Maintenance Committee and to external payment variance vendors to leverage contract terms and mitigate revenue leakage and denials.
- Help design and implement improvements to established or proposed reimbursement process flows in an effort to maximize potential revenue.
Work with Compliance, Finance and Government insurance follow up teams to stay abreast of legislative changes impacting revenue and driving payment variances.
Initiate contact with technical teams to work through technical builds and enhancements for the Payment Variance team.
Minimum Qualifications
- High School Diploma or equivalent, required
- Minimum of three (3) years of experience in revenue cycle insurance follow up or denial management, required
- Extensive knowledge of managed care contract interpretation, required
- Associate's Degree, preferred- At least three (3) years of work experience in a complex invoice/billing/reconciliation environment, preferred
Physical Requirements:
Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching.Location:
Peaks Regional OfficeWork City:
BroomfieldWork State:
ColoradoScheduled Weekly Hours:
40The hourly range for this position is listed below. Actual hourly rate dependent upon experience.
$20.87 - $35.88We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a generous benefits package that covers a wide range of programs to foster a sustainable culture of wellness that encompasses living healthy, happy, secure, connected, and engaged.
Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers , and for our Colorado, Montana, and Kansas based caregivers our commitment to diversity, equity, and inclusion .
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