Vail Health

Billing Specialist

• Responsible for collection activities including but not limited to insurance follow-up, resolving denials & rejections, submitting re-bills, re-submit claims, and file appeals.
• Acts as the back-up for the billing function, posts charges and submits insurance claims.
• Completes required reports and assists with special projects as assigned.
• Backs up other front office positions as needed.
• Performs claims follow-up by working aging and denials.
• Applies knowledge of insurance contracts and medical procedure reimbursement.
• Coordinates resubmission of claims when necessary.
• Submits appeals with supporting documentation when warranted.
• Identifies denial trends and works with management and payers to resolve issues.
• Contributes to team effort to meet collection goals and reduce A/R days.
• Investigates insurance overpayments and submits refund requests to department manager.
• Exhibits strong problem-solving and research skills to ensure solutions are found.
• Role models the principles of a Just Culture and Organizational Values.

Security Engineer

• Configures, maintains, and optimizes Epic Contract Management to reflect payer contracts, rates, and reimbursement rules.
• Translates contract language into Epic system build for appropriate modeling of terms, conditions, and reimbursement methodologies.
• Conducts contract load validation, modeling, and testing to ensure accuracy of expected reimbursement calculations.
• Collaborates with Managed Care teams to review new and updated payer contracts, ensuring accurate system representation.
• Partners with Revenue Integrity and Finance to monitor underpayments, variances, and trends, providing insights for recovery and process improvement.
• Develops, maintains, and distributes reports and dashboards to support contract performance monitoring.
• Provides end-user support, training, and documentation related to Epic Contract Management functions.
• Acts as liaison between IT and operational stakeholders, ensuring system solutions meet business needs.
• Maintains knowledge of industry best practices, CMS regulations, and payer reimbursement methodologies.
• Leverages Epic analytics platforms to assist with driving operational outcomes for the health system.
• Performs other duties as assigned. Must be HIPAA compliant.

IT Security Architect

Administrative Assistant

• Maintain up-to-date and compliant credentialing files for providers, including licensure, DEA, insurance, and certification tracking
• Monitor expirables and manage timely renewal and documentation of credentials
• Prepare and submit provider enrollment and re-credentialing applications for Medicare, Medicaid, and commercial payers
• Manage CMS provider revalidations and update provider information across portals including CAQH, PECOS, Availity, and NPPES
• Coordinate hospital credentialing and reappointment processes and serve as liaison with medical staff offices
• Maintain provider rosters, enrollment spreadsheets, and credentialing trackers; securely manage provider passwords and sensitive documentation
• Collaborate with billing teams to resolve enrollment-related claim issues and respond to payer documentation requests
• Provide administrative support to the Supervisor of Provider Services and Provider Operations Department
• Support ad hoc operational and project-related tasks and role model Just Culture and Organizational Values

Billing Specialist

IT Security Architect

Credentialing and Administrative Support Specialist