Insurance Control Specialist

Specialist

Remote

April 10, 2026

Application ends: July 9, 2026

REQUIREMENTS

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).

RESPONSIBILITIES

Perform 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.