Talent.com
Reimbursement Specialist Contract Compliance
Reimbursement Specialist Contract ComplianceNew Mexico Staffing • Broomfield, CO, US
Reimbursement Specialist Contract Compliance

Reimbursement Specialist Contract Compliance

New Mexico Staffing • Broomfield, CO, US
[job_card.variable_hours_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Reimbursement Specialist

The Reimbursement Specialist is responsible for performing a variety of complex duties, including working insurance claims follow-up and escalations, interpreting contract language, and tracking trends. This specialist works facility claims ("Hospital billing") and maintains inventory (work queue lists) at acceptable aging levels by prompt review and follow up of claims. Performs all duties in a manner which promotes teamwork and reflects Intermountain mission, vision and values.

Essential Functions

  • Responsible for the accurate and timely submission of reconsiderations and disputes.
  • Responsible for maintaining work queues at acceptable ageing, by updating accounts and tracking trends.
  • Research and resolve a variety of issues relating to payment discrepancies.
  • Identify issues and / or trends and communicate findings to management, including payer, system or registration issues.
  • Maintain basic understanding and knowledge of health insurance plans, policies and procedures.
  • Accurately and thoroughly document findings and actions taken while meeting / exceeding productivity and quality standards
  • Participate and attend meetings and training to develop job knowledge and communicate with other caregivers.

Skills

  • Microsoft Office
  • Computer literacy
  • HIPAA regulations
  • Communication (oral and written)
  • Accountability / ability to work independently
  • Contract Interpretation
  • Customer Service
  • Read and interpret EOB's (Explanation of Benefits)
  • Knowledge of medical billing and collections
  • Medical terminology
  • Participate and lead special projects, as assigned. Oversee work flow implementation with internal and external partners. Compile and coordinate materials and feedback on special projects. Trains and mentors new associates to the department. Serves as a subject matter expert and resource to answer questions within the department.
  • Minimum Qualifications

  • High School Diploma or equivalent, required
  • Must obtain CSPR or CRCR credentials with 1 yrs of hire date (provided through employer)
  • 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
  • Knowledge of revenue and ICD 10 coding practices
  • 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. $24.00 - $36.54

    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.

    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.

    [job_alerts.create_a_job]

    Reimbursement Specialist • Broomfield, CO, US

    [internal_linking.related_jobs]
    Content Compliance Reviewer (Remote)

    Content Compliance Reviewer (Remote)

    Scale AI • Denver, Colorado, United States
    [filters.remote]
    [job_card.full_time]
    Join a global community of talented professionals to shape the future of AI.Earn up to $15 USD / hr and additional rewards based on quality of submission. Outlier is committed to improving the intelli...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Remote Insurance Underwriters - AI Trainer ($50-$80 per hour)

    Remote Insurance Underwriters - AI Trainer ($50-$80 per hour)

    Mercor • Longmont, Colorado, US
    [filters.remote]
    [job_card.full_time]
    Role Overview • • Mercor is seeking experienced insurance underwriting professionals to collaborate with a technology-driven risk analytics partner. Freelancers will support the development and evalua...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Debt Resolution Specialist- Collections

    Debt Resolution Specialist- Collections

    Rausch Sturm LLP • Greenwood Village, CO, United States
    [job_card.full_time]
    For you, serving others is a way of life.You love helping people reach their goals.You can also tell when someone's truly listening versus waiting for their turn to speak.Among friends and family, ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    TurboTax Customer Service Specialist - Remote ($18.50 per hour plus Bonus)

    TurboTax Customer Service Specialist - Remote ($18.50 per hour plus Bonus)

    TurboTax • Broomfield, Colorado
    [filters.remote]
    [job_card.full_time]
    Work from home with TurboTax Product Expert.Get a $405 Certification bonus³.Work from home & set your own flexible schedule between 8am EST and 12am midnight EST Monday to Sunday⁴.Earn an ...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Regional Director Clinical Operations needed for Physical Therapy group in the outskirts of Denver (

    Regional Director Clinical Operations needed for Physical Therapy group in the outskirts of Denver (

    HealthPlus Staffing • Broomfield, CO, US
    [job_card.full_time]
    Hours : 24-32 hours / week administrative and 8-16hours of patient care.Duties : Day to day oversight / management of Clinical Operations. Overall responsibility of company growth and profitability.Job ...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Risk & Independence Contract Specialist Senior Manager - Managed Services

    Risk & Independence Contract Specialist Senior Manager - Managed Services

    Colorado Staffing • Denver, CO, US
    [job_card.full_time]
    Risk And Compliance Team Senior Manager.At PwC, our people in risk and compliance focus on maintaining regulatory compliance and managing risks for clients, providing advice, and solutions.They hel...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Tax Senior Manager- Real Estate Tax Credits

    Tax Senior Manager- Real Estate Tax Credits

    Plante Moran • Broomfield, CO, United States
    [job_card.full_time]
    Our "we-care" culture is more than just a motto; it's a promise.From day one, we prioritize your growth, well-being, and success. You can count on us to support your career journey and help you achi...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Remote Sales Representative

    Remote Sales Representative

    Globe Life American Income Division • Longmont, CO, US
    [filters.remote]
    [job_card.full_time]
    Discover your next step at Globe Life American Income Division! As we expand into new territories, we are looking for dedicated professionals wanting to elevate their career.In this role, you’ll ta...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Crisis Specialist I

    Crisis Specialist I

    Solari, Inc. • Denver, CO, United States
    [job_card.full_time]
    Work Location : Remote - Applicants must live in Colorado.Positions are full-time with opportunities for shift differential pay based on 1st, 2nd, or 3rd shift schedules. Minimum of a GED / High School...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Product Compliance Manager

    Senior Product Compliance Manager

    Empower Retirement • Greenwood Village, CO, United States
    [job_card.full_time]
    Our vision for the future is based on the idea that transforming financial lives starts by giving our people the freedom to transform their own. We have a flexible work environment, and fluid career...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    OUTREACH VICTIMS ADVOCATE

    OUTREACH VICTIMS ADVOCATE

    City of Longmont Colorado • Longmont, CO, United States
    [job_card.full_time]
    Return to Employment Opportunities.Copy Direct To Application Link.Target" style=" mdc-ripple-fg-size : 28px; mdc-ripple-fg-scale : 1.[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Remote Customer Service Representative – Product Testing

    Remote Customer Service Representative – Product Testing

    GLOCPA • Berthoud, Colorado
    [filters.remote]
    [job_card.full_time]
    We’re looking for Customer Support Product Testers across the US to work from home and help top brands improve their products before they hit the market.[show_more]
    [last_updated.last_updated_30] • [promoted]
    Crisis Specialist I

    Crisis Specialist I

    Solari • Denver, CO, US
    [job_card.full_time]
    Work Location : Remote - Applicants must live in Colorado.Positions are full-time with opportunities for shift differential pay based on 1st, 2nd, or 3rd shift schedules. Minimum of a GED / High School...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Compliance Specialist - Contracts

    Compliance Specialist - Contracts

    Trilon Group • Denver, Colorado, US
    [job_card.full_time]
    [filters_job_card.quick_apply]
    Remote opportunities may be available for the right candidate.At Horrocks, we believe the best work comes from companies with values, that our people are our greatest resource, and that we have a r...[show_more]
    [last_updated.last_updated_variable_days]
    Med Tech / QMAP

    Med Tech / QMAP

    The Bridge at Longmont • Longmont, CO, United States
    [job_card.full_time]
    Hiring for full-time Morning, Evening, & NOC Shifts (6am - 2pm) (2pm - 10 : 30pm) (10 : 30pm-6am).Current Shifts Available : Full Time-Friday-Monday & Monday-Friday. Ideal candidate will have flexibility...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Treasury Management Client Service Specialist

    Treasury Management Client Service Specialist

    BankTalent HQ • Denver, CO, United States
    [job_card.full_time]
    Zions Bancorporation is one of the nation's premier financial services companies operating as a collection of great banks under local brands and management teams in high-growth western markets.Zion...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Premium Private Practice Opportunity

    Premium Private Practice Opportunity

    Unified Women's Healthcare • Westminster, US
    [job_card.full_time]
    Are you looking for a private practice opportunity that will give you exceptional work / life balance while allowing you to practice evidence?based medicine with true practice autonomy!.Unified Women...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Contracts Specialist

    Senior Contracts Specialist

    AmerisourceBergen Corporation (Cencora) • Denver, CO, United States
    [job_card.full_time]
    Our team members are at the heart of everything we do.At Cencora, we are united in our responsibility to create healthier futures, and every person here is essential to us being able to deliver on ...[show_more]
    [last_updated.last_updated_30] • [promoted]