RCM Contract Support Specialist

Integrated Home
Any Location, FL
Category Finance
Job Description
IHCS provides an Integrated Delivery System in the home setting, which includes, DME, Respiratory, Home Health and Home Infusion services. We operate with the sole intent of providing the highest quality in-home care services that improve and enhance the daily living for our patients, where our patients are #1. We are seeking a RCM Contract Support Specialist to lead and deliver projects related to the development and configuration of new business, insurance contracts, provider contracts, new pricing and editing.

Requirements

  • Interpret insurance contract pricing tables as well as additional business requirements.
  • Translate standard business requirements into functional requirements, specified to an appropriate level of detail.
  • Collaborate with system vendors, IT, and integration teams to troubleshoot configuration limitations, defects, and enhancements.
  • Assess financial impact of configuration decisions and errors, ensuring alignment with revenue integrity and compliance requirements.
  • Follow procedures to manage major system configuration projects, including claims business rule set up outlier management.
  • Monitor payer, regulatory, and coding updates to proactively adjust system configuration as requirements evolve.
  • Perform quality review of completed configuration, assess outcomes and manage remediation of any noted discrepancies.
  • Collaborate with billing management team to resolve claim issues due to system configuration issues and make proper corrections.
  • Provide support to the billing team and related business areas.
  • Support functional areas with the creation of help sheets and training materials.
  • Review data post system implementation to ensure accuracy of configuration.
  • Share accountability for realization of results with process owners and assist in presentation of recommendations to stakeholders.
  • Identify and analyze trends by researching and responding to claims configuration requests, problem reports, and inquiries.
  • Identify areas of improvement in existing work processes, and provide recommendations.
  • Monitor configuration-driven performance metrics such as denial rates, AR aging, and underpayments to evaluate effectiveness of system rules.
  • All other related duties as assigned

Benefits

  • Medical
  • Vision
  • Dental
  • Short-term insurance
  • Long-term insurance
  • 6+ Days of Holidays Pay
  • 17 days of PTO
  • Employer paid life insurance
  • 401K with employer contribution
  • Wellness program with reward incentives
  • Employee recognition and reward programs
  • Comprehensive paid training program
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