Variance Resolution Specialist

The Variance Resolution Specialist is an advanced-level variance (credit and/or debit) position Ensures reconciliation of patient accounts with enhanced EOB/insurance processing understanding, responds accurately and timely to payers' correspondence, provides advanced credit account review with understanding of contract summaries and application to account types, and collaborates with Revenue Cycle and appropriate departments on accounts during discrepancies. Recognizes deviations from contractual expectation and payor activities or decisions, recognize gaps in payment/reasoning or system errors, handles escalated and complex accounts, audits accounts for accuracy, and works accounts to completion/resolution. Identifies trends or gaps where appropriate and follows through to ensure solutions.

Additional Information
Department Name: Patient Financial Services
Job Status: Full time, 40 hours per week
Shift: Day, 6am to 6pm. Hybrid

Duties & Responsibilities

• Reads and interprets EOB/insurance processing to understand and work and resolve accounts.
• Reads, understands, and interprets contracts and contract summaries to advise correct applications for an account.
• Recognizes and solves for deviations from contractual expectation and payor activities/decisions, recognize gaps in payment/reasoning or system errors.
• Will work projects such as Novita's, Medicaid and Medicare Audits, HMS. Supports and completes audit processes.
• Investigates and resolves assigned credit and/or debit balance accounts. Issue insurance refunds when appropriate.
• Calculates, corresponds on, and corrects contractual adjustments based on insurance contracts.
• Intermediate trending and analysis- identifying root cause and solution-oriented mindset. Recognize and call out trends within payers and escalate as appropriate.
• Proficiently discusses accounts, records, and service with patients/insurance, as needed.
• Collaborates with patients, vendors, and internal departments to resolve conflicts on accounts and resolve any outstanding credit and/or debit balances of unapplied/unidentified payment receipts.
• Identifies and prioritizes accounts and WQs, based on scoring, type, payor, dollar, etc.
• Understanding and investigation into account based on contract segments, types of accounts (i.e. outpatient, inpatient, series, etc.), thresholds, Single Case Agreements, and other requirements/components.
• Ensures accuracy in credits and/or debits processing while adhering to all regulations, objectives, operating policies and procedures, and strategic action plans for achieving goals.
• Compiles and maintains various documentation and other reporting requirements.
• Prints and mails any required hard copy forms to insurance companies, including recoupment letters, etc.

Minimum Qualifications

• Degrees
  • High School diploma or GED
• Experience
  • Minimum Experience. Required: Five (5) years of healthcare and/or accounts receivable experience.

Salary Information
Pay is dependent on applicant's relevant experience.

Hourly Range: $22.20 to $33.30

Benefits Information
Here, you matter. As a Children's Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April.

Children's Colorado delivers annual base pay increases to eligible team members based on their performance over the previous year.

EEO Statement
It is our intention that all qualified applicants be given equal opportunity and that selection decisions be based on job-related factors. We do not discriminate on the basis of race, color, religion, national origin, sex, age, disability, or any other status protected by law or regulation. Be aware that none of the questions are intended to imply illegal preferences or discrimination based on non-job-related information. The position is expected to stay open until the posted close date. Please submit your application as soon as possible as the posting is subject to close at any time once a sufficient pool of qualified applicants is obtained.

Colorado Residents: In any materials you submit, you may redact or remove age-identifying information such as age, date of birth, or dates of attendance at or graduation from an educational institution. You will not be penalized for redacting or removing this information.