Reimbursement Specialist Contract Compliance - Boston, United States - Intermountain Health

Intermountain Health Boston, United States

3 weeks ago

Description

Job Description:
No Summary Available

Practice 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 Managed Care to ensure knowledge and interpretation of managed care contracts are aligned with original intent of health system contracting efforts.

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.

Anticipated job posting close date:
05/29/2024

Location:
Peaks Regional Office

Work City:
Broomfield

Work State:
Colorado

Scheduled Weekly Hours:
40

The hourly range for this position is listed below. Actual hourly rate dependent upon experience.

$ $36.24

We 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 ) ; and our commitment to diversity, equity, and inclusion ) .

Intermountain Health is an equal opportunity employer.

Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.

Intermountain Health is a Utah-based, not-for-profit system of 33 hospitals (includes "virtual" hospital), a Medical Group with more than 3,800 physicians and advanced practice clinicians at about 385 clinics, a health plans division called Select Health, and other health services.

Helping people live the healthiest lives possible, Intermountain is widely recognized as a leader in clinical quality improvement and efficient healthcare delivery.

Join our world-class team and embark on a career filled with opportunities, strength, innovation, and fulfillment.

To find out more about us, head to our career site here ) .

Sign up for job alerts Click 'sign in' at the top right corner, create a candidate account, and when we have opportunities that meet your interests, you will receive an email with the job details.

Intermountain Health strives to make the application process accessible to all users.

If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact or email .

This contact information is for accommodation requests only and cannot be used to inquire about the status of applications.

We intentionally work toward an Intermountain Health that reflects our diverse communities and provides culturally competent care, health equity, and a sense of belonging amongst all our caregivers (employees).

This is an important part of fulfilling our mission to help people live the healthiest lives possible.

The three pillars of our work are talent experience with Intermountain (application, internship, development, etc.), community benefit, and care delivery.

Learn more about diversity at Intermountain, here. )

Introduce yourself to our Talent Acquisition team and we will get in touch if there is a role that seems like a good match.

Intermountain Health's PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution.

The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates.

Caregivers are eligible to participate in PEAK on day 1 of employment. Learn more. )

The primary intent of this job description is to set a fair and equitable rate of pay for this classification.

Only those key duties necessary for proper job evaluation and/or labor market analysis have been included. Other duties may be assigned by the supervisor.

All positions subject to close without notice.

Thanks for your interest in continuing your career with our team

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