RCM Contract Support Specialist

Integrated Home Care Services (IHCS) provides a comprehensive Integrated Delivery System in the home setting, offering Durable Medical Equipment (DME), Respiratory, Home Health, and Home Infusion services. Through our select network of Medicare and Medicaid Certified and Accredited providers, we are available 24/7 to meet the needs of our patients with compassion, expertise, and excellence. For more than 30 years, we have been dedicated to improving lives by delivering the highest quality in-home care services. As a trusted market leader in value-based Home Health, Durable Medical Equipment, and Home Infusion Services, we proudly serve more than 2 million lives across the United States and the Commonwealth of Puerto Rico. Our integrated care model is trusted by leading Managed Care Organizations (MCOs), physicians, and healthcare partners because of our commitment to exceptional patient outcomes and coordinated care. At IHCS, our patients are at the heart of everything we do. We believe in creating a culture built on compassion, integrity, collaboration, and innovation. Every team member plays a vital role in fulfilling our mission of enhancing the quality of life for those we serve through Exceptional Customer Service, Proven Outcomes, and Seamless Care. If you are passionate about making a meaningful impact, thrive in a collaborative environment, and are committed to excellence, we invite you to join our growing team. Together, we can continue transforming home healthcare while making a difference in the lives of our patients and the communities we serve. Offering a competitive compensation package, including but not limited to; Medical, Vision, Dental, Short- and Long-term insurance 6+ Days of Holidays Pay 17 days of PTO Employer paid life insurance 401K with employer contribution Wellness program with reward incentives Employee recognition and reward programs What will you be doing: Lead and deliver projects related to the development and configuration of new business, insurance contracts, provider contracts, new pricing and editing. Manage the enhancements, compliance and system enhancements. Ensures that ongoing activities are performed according to established policies and procedures as well as applicable state regulations and specific contractual provisions. What will you need to succeed: Interpret insurance contract pricing tables as well as additional business requirements. Translate standard business requirements into functional requirements, specified to an appropriate level of detail. Collaborate with system vendors, IT, and integration teams to troubleshoot configuration limitations, defects, and enhancements. Assess financial impact of configuration decisions and errors, ensuring alignment with revenue integrity and compliance requirements. Follow procedures to manage major system configuration projects, including claims business rule set up outlier management. Monitor payer, regulatory, and coding updates to proactively adjust system configuration as requirements evolve. Perform quality review of completed configuration, assess outcomes and manage remediation of any noted discrepancies. Collaborate with billing management team to resolve claim issues due to system configuration issues and make proper corrections. Provide support to the billing team and related business areas. Support functional areas with the creation of help sheets and training materials. Review data post system implementation to ensure accuracy of configuration. Share accountability for realization of results with process owners and assist in presentation of recommendations to stakeholders. Identify and analyze trends by researching and responding to claims configuration requests, problem reports, and inquiries. Identify areas of improvement in existing work processes, and provide recommendations. Monitor configuration-driven performance metrics such as denial rates, AR aging, and underpayments to evaluate effectiveness of system rules. All other related duties as assigned IHCS is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Qualifications Behaviors Preferred Team Player : Works well as a member of a group Thought Provoking : Capable of making others think deeply on a subject Enthusiastic : Shows intense and eager enjoyment and interest Dedicated : Devoted to a task or purpose with loyalty or integrity Motivations Preferred Ability to Make an Impact : Inspired to perform well by the ability to contribute to the success of a project or the organization Flexibility : Inspired to perform well when granted the ability to set your own schedule and goals Goal Completion : Inspired to perform well by the completion of tasks Job Security : Inspired to perform well by the knowledge that your job is safe Self-Starter Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws.For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr Integrated Home Care Services, Inc.