Insurance Control Specialist

MedAmerica • Sacramento, CA

2d • $21 - $26 • Remote

About The Position

At Vituity you are part of a larger team that is driven by our purpose to improve lives. We are dedicated to transforming healthcare through our culture by working together to tackle healthcare’s most pressing challenges from the inside.
Join the Vituity Team. At Vituity we’ve cultivated an environment where passion thrives, and success comes through shared purpose. We were founded in a culture that values team accomplishments more than individual achievements, an approach we call “culture of brilliance.” Together, we leverage our strengths and experiences to make a positive impact in our local communities. We foster this through shared goals and helping our colleagues succeed, and we also understand the importance of recognition, taking the time to show appreciation and gratitude for a job well done.
Vituity Locations: Vituity has opportunities at 475 sites across the country, serving 9 million patients a year. With Vituity, if you ever need to move, you can take your job with you.
The Opportunity
Perform comprehensive D120 research and creation, including assignment of valid FSC codes, appropriate no activity days, and applicable timely filing deadlines.
Create and apply FSC entries to associated D120s, as needed.
Maintain and update accurate no activity days and timely filing deadlines across all D120, FSC, and D120/FSC combinations.
Perform quality control for D48012 (dictionary mapping), D120, and D19 (FSC) dictionary records to ensure accurate mapping and system integrity.
Assign generic insurances to the correct FSC and D120 values.
Collaborate with regional teams and cross-functional departments, including Payments and PDR (Provider Disputes), to ensure ongoing accuracy and completeness of D48012 insurance mapping.
Work the daily ERA (Electronic Remittance Advice) scrub report, which identifies edits and mismatches in data prior to electronic remittance posting; conduct timely research and resolution.
Act as a resource for new teams transitioning to the IDX system, providing assistance with initial and ongoing insurance mapping and configuration needs.
Ensure adherence to internal processes and external payer guidelines while identifying opportunities for process improvement.
Document and escalate discrepancies or system errors to the appropriate team for resolution.
Maintain current knowledge of payer policies, system updates, and organizational standards impacting insurance controls.
Even when you are working remotely, you are an important part of the Vituity Community. We offer plenty of opportunities to engage with other Vitans through a variety of virtual meet-and-greets, events and seminars.
Monthly wellness events and programs such as yoga, HIIT classes, and more
Trainings to help support and advance your professional growth
Team building activities such as virtual scavenger hunts and holiday celebrations
Flexible work hours
Vituity cares about the whole you. With our comprehensive compensation and benefits package, we are mindful of what matters most, and support your needs of today and your plans for the future.
Superior health plan options
Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%25
Outstanding Paid Time Off: 3-4 weeks’ vacation, Paid holidays, Sabbatical
Student Loan Refinancing Discounts
Professional and Career Development Program
EAP, travel assistance, and identify theft included
Wellness program
Purpose-driven culture focused on improving the lives of our patients, communities, and employees
We are excited to share the base salary range for this position is $20.80 – $25.83, exclusive of fringe benefits or potential bonuses. This position is also eligible to participate in our annual corporate Success Sharing bonus program, which is based on the company’s annual performance. If you are hired at Vituity, your final base salary compensation will be determined based on factors such as skills, education, and/or experience. We believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Please speak with a recruiter for more details.
We are unified around the common purpose of transforming healthcare to improve lives and we believe everyone has a role to play in that. When we work together across sites and specialties as an integrated healthcare team, we exceed the expectations of our patients and the hospitals and clinics we work in. If you are looking to make a difference, from clinical to corporate, Vituity is the place to do it. Come grow with us.
Vituity does not discriminate against any person on the basis of race, creed, color, religion, gender, sexual orientation, gender identity/expression, national origin, disability, age, genetic information (including family medical history), veteran status, marital status, pregnancy or related condition, or any other basis protected by law. Vituity is committed to complying with all applicable national, state and local laws pertaining to nondiscrimination and equal opportunity.
Benefits for part-time and per diem vary. Please speak to a recruiter for more information.
Applicants only. No agencies please.

Requirements

• High School Diploma or GED required.
• One (1) year of experience in an Accounts Receivable Specialist role OR a minimum of two (2) years of experience in Revenue Cycle Management or a related healthcare administrative role required.
• At least three (3) months of experience working within the Athena IDX system preferred.
• Familiarity with D120, FSC, and D48012 dictionaries and mapping processes in an RCM environment preferred.
• Strong knowledge of healthcare insurance processes and terminology.
• Excellent verbal and written communication skills to work effectively across multiple departments.
• Strong collaboration skills with the ability to work in cross-functional and regional teams.
• Effective problem-solving and critical thinking skills to resolve mapping and system discrepancies.
• High level of attention to detail, accuracy, and organization.
• Ability to manage multiple tasks and priorities in a fast-paced environment.
• Proficiency with Microsoft Office Suite (Excel, Outlook, Word).

Responsibilities

• Perform comprehensive D120 research and creation, including assignment of valid FSC codes, appropriate no activity days, and applicable timely filing deadlines.
• Create and apply FSC entries to associated D120s, as needed.
• Maintain and update accurate no activity days and timely filing deadlines across all D120, FSC, and D120/FSC combinations.
• Perform quality control for D48012 (dictionary mapping), D120, and D19 (FSC) dictionary records to ensure accurate mapping and system integrity.
• Assign generic insurances to the correct FSC and D120 values.
• Collaborate with regional teams and cross-functional departments, including Payments and PDR (Provider Disputes), to ensure ongoing accuracy and completeness of D48012 insurance mapping.
• Work the daily ERA (Electronic Remittance Advice) scrub report, which identifies edits and mismatches in data prior to electronic remittance posting; conduct timely research and resolution.
• Act as a resource for new teams transitioning to the IDX system, providing assistance with initial and ongoing insurance mapping and configuration needs.
• Ensure adherence to internal processes and external payer guidelines while identifying opportunities for process improvement.
• Document and escalate discrepancies or system errors to the appropriate team for resolution.
• Maintain current knowledge of payer policies, system updates, and organizational standards impacting insurance controls.

Benefits

• Superior health plan options
• Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%25
• Outstanding Paid Time Off: 3-4 weeks’ vacation, Paid holidays, Sabbatical
• Student Loan Refinancing Discounts
• Professional and Career Development Program
• EAP, travel assistance, and identify theft included
• Wellness program
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED