Job Description

Category:
Administrative/ Clerical

Facility:
Corporate

Department:
Revenue Management

Req Number:
52341

Job Details:
Job Summary:
This position is responsible for providing leadership and subject matter expertise relative to forecasting, calculating and capturing all net revenue contractually owed by the payers.

Responsibilities:
  • Independently manage and monitor daily work related to identifying net revenue contractually owed.
  • Experience with a contract management tool to manage contract inventories and simply the reimbursement process by calculating expected payments.
  • Experience interpreting managed and commercial payer contract language, state/federal payer regulations and how it relates to pricing claims.
  • Understand the process to identify, research and resolve over/under payments.
  • Manage the daily operations the revenue integrity unit including productivity, quality, hours-worked, development needs and other aspects of employee/team performance.
  • Assist in the evaluation and recommendations of programs, procedures for improved operations, modifications to and/or implementation of new procedures.
  • Identify and work with the director to resolve problems with CBO processes and when appropriate, initiate changes to prevent future problems.
  • Assist in establishing long and short term unit goals and objectives to support department and corporate strategic plan.
  • Maintain professional competency, according to department policies, procedures and protocols.
  • Maintain a repository of knowledge required to train new revenue cycle associates including manuals, tip sheets and other materials.
  • Maintain strict confidentiality and adheres to all HIPAA guidelines/regulations.

Qualifications:
  • Associate's degree required; Bachelors preferred.
  • 4 years minimum experience in hospital billing with specific payer(s) subject matter expertise.
  • Demonstrated ability to manage teams or groups of colleagues.
  • Experience with patient accounting systems, billing/claim submission software required.
  • Specific XClaim and/or Meditech experience a plus.
  • Possess ability to investigate, analyze and in coordination with management, resolve departmental issues.
  • Possess ability to work efficiently and accurately, and to organize and plan work.
  • Possess flexibility and adaptability to work additional hours and to work under stress.
  • Ability to establish and maintain effective working relationships and communicate clearly with customers both within and outside of Steward.
  • Highly detail oriented and well organized; ability to multitask.



Application Instructions

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