Kootenai Health

Insurance Reimbursement Specialist I

Position Summary

Responsible for the timely and compliant submission of technical (hospital) and professional claims (HB and PB) to insurance companies, government agencies and patients, meeting “Steady State” performance requirements.

Responsibilities

• Consults with coders, as needed, to adjust coding modifiers to ensure clean claims submissions
• Coordinates information with other departments to resolve billing and potential reimbursement issues
• Researches and resolves unbillable claims
• Supports Accounts Receivable Collections efforts by providing claims processing and research information sufficient for follow-up and appeal of claims denial
• Supports Registration, Customer Service, Billing and Accounts Receivable Collections functions
• Interacts with patients, clinicians, insures, and billing management to ensure timely submission of claims
• Perform duties in compliance with state and federal regulatory requirements, and Kootenai Health policies and procedures governing Revenue Cycle compliant processes
• Performs other related duties as assigned
• Familiar with standard concepts, practices, and procedures within the field
• Regular and predictable attendance is an essential job function
• Competent to meet age specific needs of the unit assigned

Requirements and Minimum Qualifications

• High school diploma preferred, Billing Specialist Certification or Associates degree preferred
• 3 years’ experience working in a hospital or medical office with current commercial and government payer types, and understanding of payment methodologies
• Prefer at least 1 year hands-on experience processing 1500 or UB billing forms
• Demonstrated ability to navigate through commercial payer and government agency websites, to research and understand billing requirements and instruction, and regulatory guidelines
• Demonstrated ability working in hospital and professional EMR billing, and supporting eligibility systems, and ability to read and understand a patient medical record sufficient to conduct HB or PB claims-related research
• Medical terminology familiarity required
• Excellent communication, organizational and analytical skills required
• Ability to work well in a team environment, and independently with minimum supervision
• Knowledge and demonstrated competence working with Microsoft Office software, to include Excel, Word, and e-mail programs

Working Conditions

• Must be able to lift and move up to 10 lbs
• Must be able to reach arms above or below shoulder height
• Must be able to maintain a sitting position
• Typical equipment used in an office job
• Repetitive movements
• Remote eligible

About Kootenai Health:

Kootenai Health is a highly esteemed healthcare organization serving patients throughout northern Idaho and the Inland Northwest. We have been recognized with many accolades and distinctions, including being a Gallup Great Workplace, No. 1 Best Place to Work in Large Healthcare Organizations, and Magnet™ Status for Nursing Excellence. We pride ourselves on our outstanding reputation as an employer and a healthcare provider.

As your next employer, we are excited to offer you:

• Kootenai Health offers comprehensive medical plan options, including options for fully paid employer premiums for our full-time employees. For part-time employees, we offer the same plan options with affordable part-time premiums. In addition to medical insurance, we offer many voluntary benefits ranging from dental and vision to life and pet insurance. Kootenai Health also offers well-being resources and telemedicine service options to all employees, regardless of benefit eligibility. Benefits begin on the 1st of the month following 30 days of employment.
• Kootenai Health’s tuition assistance program is available after 90 days. If you want to further your education, we'll help you pay for it
• Kootenai Health sponsors retirement plans for employees that enable you to save money on a pre-tax and Roth after tax basis for your retirement. Kootenai Health will match your contributions based on years of service ranging from 3-6 percent.
• Competitive salaries with night, weekend, and PRN shift differentials
• An award-winning and incentive-driven wellness program. Including a MyHealth corporate team, onsite financial seminars, and coaching
• Employees receive discounts at The Wellness Bar, PEAK Fitness, and more
• Robust and interactive employee referral program
• And much more

Kootenai Health provides exceptional support for extraordinary careers. If you want to work on a high-quality, person-centered healthcare team, we can't wait to meet you!

Apply today! Please contact the HR Front Desk at 208-625-4620 or email careers@kh.org with any questions.

Kootenai Health complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, veteran status, or sex. Kootenai Health does not exclude people or treat them differently because of race, color, national origin, age, disability, veteran status, or sex.