Health System Specialist

Health System Specialist

Coordinates operations across distinct reimbursement programs-Medicare, Medicaid, Private Insurance, Children's Health Insurance Program, and Veterans Affairs-maintaining and improving the reimbursement system in compliance with the Resource Operations Manual and other applicable rules and regulations.

Serves as principal advisor to the Director of Revenue and other Area program managers on Business Office matters, and as the primary point of contact for Billings Area programs and staff on third-party reimbursement issues.

Serves as system manager for all Resource and Patient Management System (RPMS) Business Office applications, including Patient Registration, Third Party Billing, and Accounts Receivable.

Establishes and maintains liaison with community, tribal, state, and federal agencies and professional organizations-including IHS Headquarters, CMS Regional Centers, State Medicaid offices, fiscal intermediaries, and billing clearinghouses-to plan program priorities and policy, and ensures Area and Service Unit compliance with IHS and federal statutes and regulations.