Revenue Cycle Specialist I

Claims Follow-Up Specialist

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.

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

$19.41 - $28.14

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.