Claims Payment Controller

Job Description:

We are committed to offering flexible work options where approved and stated in the job posting. However, we are currently not considering candidates who reside or plan to reside in the following states: California, Connecticut, Hawaii, Illinois, New York, Pennsylvania, Rhode Island, Vermont, and Washington. 

Please note that a video interview through Microsoft Teams will be required as well as potential onsite interviews and meetings 

Schedule

• This teammate will be working a M-F schedule, 8 hours a day, 40 hour work week. Full time position. Days off will consist of IHC holidays. 

Job Functions

1. Oversight of payment activities including Fee-for-Service and Capitation payments.

2. Close collaboration with Finance department to ensure all payments and bank transfers are

reconciled.

3. Continuous development and implementation of payment process.

4. Be a liaison between Intermountain Nevada and its provider community.

5. Verify all payments process are followed and documenting for FRCF reconciliation.

6. Escalation of vendor provider payment concerns, frustrations, and disputes to appropriate teams.

7. Assists in projects with moderately complex system modifications/updates.

8. Perform escheatment process for uncollected payments

9. Collaborate with PCR and Finance to produce Revenue Cycle quarterly reports for Service Line leaders keeping leadership informed of trends, issues, and concerns.

10. Analyze reports from multiple sources and meet routinely with front line leadership to simplify concerns, creation actionable steps, and set goals moving forward.

11. Ensure better controls over all payment cycle operations to make the MSO more profitable.

12. Tracking of missing payments and ensuring they are correctly reissued.

13. Performs other work-related duties and responsibilities as directed, assigned or requested.

Provides expert-level skill in all areas of provider/vendor payment. Responsible for over $1 billion dollars per year in fee-for-service and capitation payments to our community of healthcare providers. Works closely with our payment vendor to ensure timely payments are made, resolve system issues, coordinate system upgrades, and deliver on new payment options as they become

available. Partners with Intermountain Nevada Finance team to ensure funds are correctly withdrawn, all policies are followed, implement the escheatment process, and to resolve discrepancies. Main point of contact for providers/vendors payment questions.

The Claims Payment Controller is responsible for ensuring the accurate and timely payment of all Intermountain Fee-for-Service and Capitation payments. The Claims Payment Controller accomplishes this by performing moderate to complex tasks within the claims and payment platforms. The position interfaces with system architects, business analysts, and corporate staff on

all payment reconciliations, troubleshooting, and system projects to support resolution of issues.

Minimum Qualifications

• 5-8 years claims processing or system set-up experience, managed care preferred 
• High School Diploma or GED required, some college preferred
• General knowledge of provider contracts, fee schedules and payment methodologies
• Knowledge of health plan benefit interpretation and set up
• Knowledge of current compliance legislation 
• Strong interpersonal skills required
• Demonstrated proficiency in MS Excel and Word required
• Strong problem-solving skills required

Preferred Qualifications

• Responsible for quality and continuous improvement within the job scope.
• Responsible for all actions/responsibilities as described in company controlled documentation for this position.
• Contributes to and supports the corporation's quality initiatives by planning, communicating and encouraging team and individual contributions toward the corporation's quality improvement efforts.

Location:

Work City:

Work State:

Scheduled Weekly Hours:

The hourly range for this position is listed below. Actual hourly rate dependent upon experience. 

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 package here.

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.

At Intermountain Health, we use the artificial intelligence ("AI") platform, HiredScore to improve your job application experience. HiredScore helps match your skills and experiences to the best jobs for you. While HiredScore assists in reviewing applications, all final decisions are made by Intermountain personnel to ensure fairness. We protect your privacy and follow strict data protection rules. Your information is safe and used only for recruitment. Thank you for considering a career with us and experiencing our AI-enhanced recruitment process.

All positions subject to close without notice.