Remote Utilization Review Manager Jobs in Vernal, UT

This position may be filled prior to the posted deadline.  Interested candidates are encouraged to apply as soon as possible.

Koniag Advisory Business Solutions, LLC a Koniag Government Services company, is seeking a Billing Technician II to support KABS and our government customer at Fort Duchesne, UT. This position requires the candidate to be able to obtain a Public Trust.

This position is covered under the Service Contract Act. Benefits include medical, dental, and vision insurance, 401(k) retirement plan, paid time off, paid parental leave, life and disability insurance, flexible spending accounts, commuter benefits and tuition reimbursement. 

Koniag Advisory Business Solutions (KABS), a Koniag Government Service Company, is seeking detail-oriented, dependable Billing Technician II professional to support The IHS local Fort Duchesne hospital and clinics. This role supports timely, compliant billing and follow-up activity for outpatient and inpatient claims and helps protect revenue integrity across third-party billing operations.

This requirement is for Billing, Debt management, Accounts Receivable, related to revenue cycle components, Reporting and Analytics for the medical, dental, and behavioral health Departments for the Uintah and Ouray (U&O) Service Unit located in Fort Duchesne, UT. 

Core working hours are generally 8:00 a.m. to 5:30 p.m. MT, with exact start and end times determined by the agency.

Remote work may be permitted at the discretion of the Uintah and Ouray Service Unit, based on operational needs and Government approval.  Telework is a temporary privilege and may be modified or rescinded at any time due to operational, client, business, or security requirements.

• Prepare and submit accurate electronic and manual claims within payer filing deadlines for Medicare, Medicaid, private insurance, FMCRA, Workers' Compensation, non-beneficiary, and other third-party payers.
• Review patient registration, EHR, coding, and billing information to ensure claims are complete, accurate, properly sequenced, and submitted to the appropriate payer.
• Verify required documentation, including Medicare Secondary Payer (MSP), Assignment of Benefits (AOB), and Release of Information (ROI) forms.
• Review and correct billing information, including visit and bill types, revenue codes, providers, dates of service, ancillary services, referrals, and third-party injury information.
• Identify billing, coding, registration, or documentation deficiencies and coordinate corrections and claim resubmissions.
• Review rejected, denied, underpaid, and outstanding claims; contact payers and prepare appeals or secondary claims as appropriate.
• Perform account follow-up and reconciliation to support timely collection of outstanding receivables and maintain aging goals.
• Maintain accurate documentation of payer contacts, account activity, claim status, and follow-up actions in RPMS and applicable IHS systems.
• Reconcile electronic claim transmission reports, correct errors, and resubmit claims when necessary.
• Maintain required billing, EOB, deficiency, flagged-claim, and accounts-receivable records and logs.
• Protect patient and medical information in accordance with HIPAA, the Privacy Act, IHS policies, and applicable healthcare requirements.
• Prepare weekly deficiency reports and weekly, monthly, quarterly, and annual billing metrics for IHS leadership.
• Participate in recurring meetings with IHS leadership and clinic staff to address billing deficiencies, payer issues, corrective actions, and program performance.
• Perform other billing, account review, reporting, and revenue-cycle support duties as assigned.

Personnel Qualifications. Minimum Qualifications:

• A minimum of two (2) years of medical billing experience, preferably in a hospital, federally operated, or Tribal healthcare setting performing medical, dental, and behavioral health billing and related revenue cycle services.
• High school diploma or high school equivalent.  
• Demonstrated familiarity with Indian Health Service (IHS), Centers for Medicare & Medicaid Services (CMS), and third-party payer billing guidelines and requirements.  
• Experience working with Electronic Health Record (EHR) systems and medical billing software. (e) Working knowledge of the Health Insurance Portability and Accountability Act (HIPAA) and patient confidentiality requirements.    

• If telework is approved, the employee must maintain a dedicated, private workspace suitable for handling confidential information and must use only authorized equipment, approved connections, and secure access methods.
• Telework may be suspended or revoked at any time if privacy, security, operational, or contractual concerns arise.

Final candidates will be required to provide documentation and information necessary to support background investigation, credentialing, and access processing, which may include:

• Government-issued identity documents for identity proofing.
• Information needed for fingerprinting and background investigation processing.
• Current address and prior residence history, as requested.
• Employment history and related verification information, as requested.
• Professional certification and training documentation, as required.
• Any other forms or supporting materials required by IHS, HHS, or authorized security officials.

Security Requirement:

• Ability to obtain a public trust

Our Equal Employment Opportunity Policy

The company is an equal opportunity employer. The company shall not discriminate against any employee or applicant because of race, color, religion, creed, ethnicity, sex, sexual orientation, gender or gender identity (except where gender is a bona fide occupational qualification), national origin or ancestry, age, disability, citizenship, military/veteran status, marital status, genetic information or any other characteristic protected by applicable federal, state, or local law. We are committed to equal employment opportunity in all decisions related to employment, promotion, wages, benefits, and all other privileges, terms, and conditions of employment.

The company is dedicated to seeking all qualified applicants. If you require an accommodation to navigate or apply for a position on our website, please get in touch with Heaven Wood via e-mail at accommodations@koniag-gs.com or by calling 703-488-9377 to request accommodations.

Koniag Government Services (KGS) is an Alaska Native Owned corporation supporting the values and traditions of our native communities through an agile employee and corporate culture that delivers Enterprise Solutions, Professional Services and Operational Management to Federal Government Agencies. As a wholly owned subsidiary of Koniag, we apply our proven commercial solutions to a deep knowledge of Defense and Civilian missions to provide forward leaning technical, professional, and operational solutions. KGS enables successful mission outcomes for our customers through solution-oriented business partnerships and a commitment to exceptional service delivery. We ensure long-term success with a continuous improvement approach while balancing the collective interests of our customers, employees, and native communities. For more information, please visit www.koniag-gs.com.

Equal Opportunity Employer/Veterans/Disabled. Shareholder Preference in accordance with Public Law 88-352