[Hiring] Insurance Control Specialist @Vituity

Role Description

This role involves performing comprehensive D120 research and creation, including assignment of valid FSC codes, appropriate no activity days, and applicable timely filing deadlines.

• Create and apply FSC entries to associated D120s, as needed.
• Maintain and update accurate no activity days and timely filing deadlines across all D120, FSC, and D120/FSC combinations.
• Perform quality control for D48012 (dictionary mapping), D120, and D19 (FSC) dictionary records to ensure accurate mapping and system integrity.
• Assign generic insurances to the correct FSC and D120 values.
• Collaborate with regional teams and cross-functional departments, including Payments and PDR (Provider Disputes), to ensure ongoing accuracy and completeness of D48012 insurance mapping.
• Work the daily ERA (Electronic Remittance Advice) scrub report, which identifies edits and mismatches in data prior to electronic remittance posting; conduct timely research and resolution.
• Act as a resource for new teams transitioning to the IDX system, providing assistance with initial and ongoing insurance mapping and configuration needs.
• Ensure adherence to internal processes and external payer guidelines while identifying opportunities for process improvement.
• Document and escalate discrepancies or system errors to the appropriate team for resolution.
• Maintain current knowledge of payer policies, system updates, and organizational standards impacting insurance controls.

Qualifications

• High School Diploma or GED required.
• One (1) year of experience in an Accounts Receivable Specialist role OR a minimum of two (2) years of experience in Revenue Cycle Management or a related healthcare administrative role required.
• At least three (3) months of experience working within the Athena IDX system preferred.
• Familiarity with D120, FSC, and D48012 dictionaries and mapping processes in an RCM environment preferred.
• Strong knowledge of healthcare insurance processes and terminology.
• Excellent verbal and written communication skills to work effectively across multiple departments.
• Strong collaboration skills with the ability to work in cross-functional and regional teams.
• Effective problem-solving and critical thinking skills to resolve mapping and system discrepancies.
• High level of attention to detail, accuracy, and organization.
• Ability to manage multiple tasks and priorities in a fast-paced environment.
• Proficiency with Microsoft Office Suite (Excel, Outlook, Word).

Benefits

• Superior health plan options
• Dental, Vision, HSA/FSA, Life and AD&D coverage, and more
• Top Tier 401(k) retirement savings plans that offers a $1.20 match for every dollar up to 6%
• Outstanding Paid Time Off: 3-4 weeks’ vacation, Paid holidays, Sabbatical
• Student Loan Refinancing Discounts
• Professional and Career Development Program
• EAP, travel assistance, and identity theft included
• Wellness program
• Purpose-driven culture focused on improving the lives of our patients, communities, and employees