Billing/Recovery Audit Specialist

St. Luke's Health System • Boise, ID

6d

About The Position

At St. Luke’s, we pride ourselves on fostering a workplace culture that values diversity, promotes collaboration, and prioritizes employee well-being. Our commitment to excellence in patient care extends to creating an environment where our team can thrive both personally and professionally. With opportunities for growth, competitive benefits, and a supportive community of colleagues, St. Luke’s is truly a great place to work. What You Can Expect: The Billing and Recovery Audit Specialist is responsible for supporting various aspects of the Revenue Cycle, including Billing, Reimbursement, and Insurance Recovery. This role ensures adherence to company policies, procedures, and related government regulations. Key responsibilities within Billing and Recovery include updating productivity metrics, performing quality assurance audits, identifying process improvements, providing training, resolving audit requests, handling complex claims, facilitating team meetings, managing compliance tasks, and participating in special projects.

Requirements

• High school diploma or equivalent
• 3 years relevant experience

Responsibilities

• Update and report productivity metrics day by day for billing and recovery staff
• Perform Quality Assurance (QA) Audits and identify trends on billing and recovery staff work
• Identify and communicate process gaps, training needs, and other areas of improvement to Billing and Recovery management
• Draft weekly communications for the Billing and Recovery team based on QA audit trends and update resource manuals as needed
• Provide group and one-on-one training to Billing and Recovery staff as needed, covering both new hire and ongoing training
• Facilitate and/or participate in weekly Billing and Recovery team meetings and huddles
• Work on internal charge and compliance audits, including rebilling, refunds and all follow-up until the audits are complete.
• Resolve payor audit records requests
• Track and coordinate resolution of Medicare Recovery Audit Contractor (RAC) audits with Corporate Compliance
• Work on complex claims including but not limited to BMT, CAR-T, Gene Therapy, NSA, Retro, ARUP
• Assist in Billing and Recovery work queues during high volume periods, staffing shortages, and with complex issues
• Assist Billing and Recovery with coverage updates for all payers
• When applicable may represent the Billing and Recovery department as a subject matter expert regarding billing, recovery, and credits
• Stay informed of payer contacts, rules, and regulations as they affect our billing guidelines and operations
• Participates in special projects or other related billing and recovery duties as assigned

Benefits

• At St. Luke’s, caring for people in the communities we serve is our mission – and this includes our own SLHS team. We offer a robust benefits package to support our teams both professionally and personally. In addition to a competitive salary and retirement plans, we ensure our team feels supported in their benefits beyond the typical medical, dental, and vision offerings. We care about you and have fantastic financial and physical wellness options, such as: on-site massages, on-site counseling via our Employee Assistance Program, access to the Personify Health Wellness tool, as well as other formal training and career development offerings to ensure you are meeting your career goals.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED
• Number of Employees: 5,001-10,000 employees