Revenue Cycle Specialist I

Intermountain Healthcare Inc.; Frankfort (KY); Remote; USD 26,000 - 39,000; Full time

Job summary

Intermountain Health is seeking a fully remote Claims Follow-Up Specialist to ensure timely follow-up on billed claims and resolution of accounts. You will maintain billing guidelines, fee schedules, and contract rates, and review all incoming correspondence and payor calls for accurate resolution with supporting documentation.

The role emphasizes researching payer issues, analyzing denial trends, and assisting with rebilling underpaid claims.

Qualifications

• High School Diploma or equivalent (GED).
• One (1) year of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections).
• Knowledge of Medicaid and Medicare billing regulations.

Responsibilities

• Follow up on claims and ensure timely resolution with supporting documentation.
• Maintain and update billing guidelines, fee schedules, and contract rates.
• Review, document, and resolve incoming correspondence and payor calls.
• Assist on aging reports and report denial trends to Lead/Supervisor.
• Appeal and/or rebill underpaid claims and assist with payments as needed.

Skills

Billing

Documentation

Communication

Customer Follow-Ups

Time Management

Medicare Billing

Medical Billing

HIPAA Regulations

Education

High School Diploma or GED

Tools

Microsoft Office

ICD coding language

Job description

Fully Remote

Peaks Regional Office

Full time

Job Description:

Responsible for the timely follow-up of claims billed and resolution of accounts. Oversees the account receivables and maintains detailed/accurate account documentation. Follow up on open claims thoroughly, accurately, promptly, and with all supporting documentation. Responsible for maintaining and updating billing guidelines, fee schedules, contract rates, etc. Review, document, and resolve all incoming correspondence and payor calls; assist as needed on aging reports, reports all payor issues and/or denial trends to Lead/Supervisor and may appeal and/or rebill underpaid claims and assist with payments, as needed.

We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, Massachusetts, Maine, Minnesota, New York, Pennsylvania, Rhode Island, Virginia Vermont, Washington.

Essential Functions

• Maintain basic understanding and knowledge of health insurance plans, policies and procedures.
• Research and follow-up on outstanding claims. Appropriately document in the system all correspondence and action for the claim.
• Follow up in accordance with procedures and policies with an overall goal of account resolution.
• Contact insurance companies to obtain information necessary for invoice or account resolution through write-offs, reversals, adjustments or other methods.
• Identify issues and/or trends and provide suggestions for resolution to management, including payer, system or escalated account issues.
• Research medical records to gather information and substantiate medical justification for procedures as required by insurance carriers.
• Submit requested medical information to insurance carrier. Responsible for the analysis and necessary corrections of invoices or accounts and maintaining work queues.
• Responsible for meeting or exceeding productivity and quality goals.

Skills

• Billing
• Documentations
• Communication
• Customer Follow-Ups
• Time Management
• Medicare Billing
• Medical Billing
• Microsoft Office
• Computer Literacy
• HIPAA Regulations

Qualifications

• High School Diploma or equivalent (GED)
• One (1) years of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections)
• Knowledge of Medicaid and Medicare billing regulations

Preferred Qualifications

• Knowledge of Revenue and ICD coding language
• Two (2) years of experience in hospital or physician insurance related activities (Authorization, Billing, Follow-Up, Call-Center, or Collections)

Physical Requirements

• Manual dexterity of hands and fingers to manipulate complex and delicate equipment with precision and accuracy. This includes frequent computer, phone, and cable set-up and use.
• Expected to lift and utilize full range of movement to transport, pull, and push equipment. Will also work on hands and knees and bend to set-up, troubleshoot, lift, and carry supplies and equipment. Typically includes items of varying weights, up to and including heavy items.

For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

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.

$19.41 – $28.14

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 package here (https://intermountainhealthcare.org/careers/benefits).

By applying for a position with Intermountain, I acknowledge that I will comply with all applicable Intermountain policies and expectations. If applying for a remote or hybrid role, this includes remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment. I further acknowledge that outside employment or activities may not interfere with job responsibilities or create a conflict of interest with Intermountain. Actual or reasonably perceived conflicts may be grounds for disqualification from consideration or, if hired, corrective action up to and including termination of employment.

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.

At Intermountain Health, we use the artificial intelligence (“AI”) platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.

Headquartered in Utah with locations in six primary states and additional operations across the western U.S., Intermountain Health is a nonprofit system of 34 hospitals, 400 clinics, a medical group of more than 4,800 employed physicians and advanced care providers, a health plan division called Select Health with more than one million members, 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 (https://intermountainhealthcare.org/careers/?utm_source=Workday&utm_medium=Redirect&utm_campaign=CareerHome_workday).

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. (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/peak-program/)

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!