Insurance Control Specialist

MedAmerica•Sacramento, CA

8h•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 has opportunities at 890 practices across the country, serving 14.5 million patients a year. With Vituity, if you ever need to move, you can take your job with you.

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.
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).

Nice To Haves

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.

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% plus discretionary profit-sharing contributions (eligible January following 18 months of service)
Generous paid time off starting 3-4 weeks’ annually
Student Loan Refinancing Discounts
Professional and Career Development Program
EAP and travel assistance included
Wellness program
Purpose-driven culture focused on improving the lives of our patients, communities, and employees
Annual corporate Success Sharing bonus program, which is based on the company’s annual performance.