Insurance Reimbursement Specialist II

• Department Revenue Cycle - Business Services

• Analyze A/R reports to perform collection follow-up on outstanding receivables, and determine the appropriate prioritization of follow-up action required
• Work with payer websites, electronic tools, phone and other mechanisms, to ensure timely and full payment from third party payers. Reviews remittance advice for no pays or short pays to verify proper reimbursement, conduct follow-up with payers, or to make adjustments as necessary
• Identifies coding and billing errors from the EOB and works with all partner departments to correct errors and re-bill in a timely manner
• Appeals improperly adjudicated claims so they are promptly corrected and paid
• Supports Revenue Cycle by providing A/R, denials and appeals information, in required reporting formats
• Supports Customer Service, Financial Counseling, and Patient Advocacy in response to patient billing inquiries or complaints
• Provide support to registration, customer service, billing and accounts receivable collections functions, as appropriate
• Interacts with patients, clinicians, insurers, and billing management to ensure timely submission of appeals and timely collection of accounts
• 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

• High school diploma preferred. Billing Specialist Certification or Associates degree preferred
• 5 years’ professional experience working in a hospital or medical office with current commercial and government payer types, and strong understanding of payment methodologies
• At least 2 years’ 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 understanding required
• Excellent communication, organizational and analytical skills required
• Ability to work equally 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 to include reporting

• 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

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…