**Job Description:** No Summary Available Scope As a Reimbursement Specialist you need to know how to: Evaluate payment variances in Epic WQs against payer contracts to determine if payer underpaid or overpaid, and dispositions variance based upon established protocols. Identify trends through reporting and data analysis and leverages data to resolve errors in Epic proration rules, payer under and/or overpayment trends, opportunities in billing, and opportunities with managed care contracting efforts. Log findings and provides feedback to Hospital Billing AR Management, Cash Management, and Managed Care leadership. Perform root cause analysis and recommends and develops process improvement. Serve as a liaison to internal teams to include the Epic Contract Maintenance Committee and to external payment variance vendors to leverage contract terms and mitigate revenue leakage and denials. - Help design and implement improvements to established or proposed reimbursement process flows in an effort to maximize potential revenue. Work with Managed Care to ensure knowledge and interpretation of managed care contracts are aligned with original intent of health system contracting efforts. Work with Compliance, Finance and Government insurance follow up teams to stay abreast of legislative changes impacting revenue and driving payment variances. Initiate contact with technical teams to work through technical builds and enhancements for the Payment Variance team. + Process Payer Plan Service Desk tickets + Network Status subject matter expert + Know and understand how each payer and plan in Epic is utilized and how it applies to specific networks and how those networks translate to our contract/rates from a high level. + Collaborate with Managed Care to determine network status + Hold quarterly meetings to update network status matrix + Epic payer and plan subject matter expert + Learn and understand the payers and plans built into Epic and how they are utilized, answer any questions on their use + As the subject matter expert, you will the be the primary for validation of information on education that gets put out to caregivers. You will collaborate with RCLD on this quite often. + RTE mapping subject matter resource + Ability to understand what is said in the RTE responses and how they mapped to which plan (or didn't) to the best of your ability. + Collaborate within the system on a regular basis to ensure all above items are running smoothly - 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. 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 - Associate's Degree, preferred - At least three (3) years of work experience in a complex invoice/billing/reconciliation environment, preferred **Physical Requirements:** Interact with others by effectively communicating, both orally and in writing.- and -Operate computers and other office equipment requiring the ability to move fingers and hands.- and -See and read computer monitors and documents.- and -Remain sitting or standing for long periods of time to perform work on a computer, telephone, or other equipment.- and -May require lifting and transporting objects and office supplies, bending, kneeling and reaching. **Location:** Peaks Regional Office **Work City:** Broomfield **Work State:** Colorado **Scheduled Weekly Hours:** 40 The hourly range for this position is listed below. Actual hourly rate dependent upon experience. $23.30 - $35.48 We care about your well-being – mind, body, and spirit – which is why we provide our caregivers a 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. Learn more about our comprehensive benefits packages for our Idaho, Nevada, and Utah based caregivers (https://intermountainhealthcare.org/careers/working-for-intermountain/employee-benefits/) , and for our Colorado, Montana, and Kansas based caregivers (http://www.sclhealthbenefits.org) ; and our commitment to diversity, equity, and inclusion (https://intermountainhealthcare.org/careers/working-for-intermountain/diversity/) . Intermountain Health is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. All positions subject to close without notice.