Payer Plan Coordinator

Intermountain Health

7d • $24 - $37 • Onsite

About The Position

An hourly position responsible for reviewing and validating all incoming payer plan tickets, then, coordinating communications with appropriate teams to determine the overall impact of changes made to payer plans to ensure the successful billing of claims across all regions within the organization.

Requirements

• High school diploma
• Must obtain CSPR or CRCR credentials within 1 year of hire date (provided through employer).
• Two (2)+ years of experience in hospital or physician insurance related activities (Billing & Follow-Up)
• Knowledge of revenue and ICD 10 coding practices
• 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.
• Minimum Qualifications - High School Diploma or equivalent, required
• 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
• At least three (3) years of work experience in a complex invoice/billing/reconciliation environment, preferred
• For roles requiring driving: Expected to drive a vehicle which requires sitting, seeing and reading signs, traffic signals, and other vehicles.

Nice To Haves

• Associate's Degree, preferred

Responsibilities

• Hosts PPGC (Payer Plan Governance Committee) for all regions
• Brings new plan requests to the meeting for discussion/approval
• Communicates new plan creation issues
• Follows up with other teams take aways
• Responsible for timely processing of Payer Plan Service Desk tickets
• Obtains votes from PPGC
• Routes tickets to contract build, ITDS, and/or RCLD
• Collaborate with Managed Care to determine network status
• Hold quarterly meetings to update network status matrix
• Learn and understand the payers and plans built into Epic and how they are utilized, answer any questions on their use
• Works with Patient Access, ITDS on challenges with RTE
• Runs reports and communicates trends to appropriate teams
• Collaborates within the system on a regular basis to ensure all above items are running smoothly, not limited to following teams
• 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.

Benefits

• 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.
• PEAK program supports caregivers in the pursuit of their education goals and career aspirations by providing up-front tuition coverage paid directly to the academic institution. The program offers 100+ learning options to choose from, including undergraduate studies, high school diplomas, and professional skills and certificates. Caregivers are eligible to participate in PEAK on day 1 of employment.

What This Job Offers

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