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Manager for Patient Accounting Revenue Recovery and Retention

Company: Stony Brook University
Location: East Setauket
Posted on: May 3, 2021

Job Description:

Position Summary

At Stony Brook Medicine, the Manager for Patient Accounting Revenue Recovery and Retention will oversee the hospital's Facility Insurance Denials, Appeals and Revenue Retention Units. Reporting to the Manager of Patient Accounting, the Revenue Recovery and Retention Manager will lead the Hospital's denied claims appeal efforts as well as manage the defense of revenue against post-payment take-back/retraction. The Manager will develop and optimize related work flows and system work queues, train staff and monitor the unit's work quality and productivity. They will track, trend and report on denied, appealed and contested accounts receivable and routinely work with Patient Accounting and Managed Care leadership to identify and resolve high dollar/high risk accounts. Successful candidates will have 5 plus years' management experience in an Acute Care Hospital Revenue Cycle or Patient Accounting Department managing staff involved in acute care facility insurance claim follow-up, appeals and/or payment variance analysis.

Duties of a Manager for Patient Accounting Revenue Recovery and Retention may include the following but are not limited to:

  • Educate staff on Managed Care Contracts including medical review and readmission policies, dispute resolution processes, appeals and payment recoupment timeframes.
  • Develop work flows and training to support facility insurance appeals and revenue retention efforts.
  • Develop and monitor work queues and staff productivity to ensure work volumes and staffing are aligned.
  • Audit staff work; provide education on best practice.
  • Analyze and report on denial and payment retraction trends and appeals volumes/outcomes.
  • Collaborate with the Managed Care Department and Patient Accounting leadership to address payment issues and resolve at risk/high dollar accounts.
  • As required, participate in Joint Operating Calls (JOC) with insurance payers.
  • Identify issues and patterns regarding non-payments and collaborate on denials prevention initiatives.
  • As required, liaise with Insurance Company Provider Representatives to resolve contested accounts.
  • Assist management reporting and special projects as requested.

Qualifications

Required Qualifications:

  • B.S. Accounting/Finance, Health Information Management, Health Administration, Computer Science or related field.
  • 5 Years' Healthcare Revenue Cycle or Patient Accounting experience managing Acute Care Facility Insurance claims follow-up, appeals and/or payment variance analysis.
  • 5 Years' experience working with an Acute Care Contract Management software system.
  • Experience participating in Insurance Joint Operating Calls and interacting with Payer Provider Representatives.
  • Expert knowledge of governmental and non- governmental healthcare facility claims reimbursement methodologies.
  • Expert knowledge of inpatient and outpatient billing requirements (UB-04, 837i). Specifically how claims information impacts/drives reimbursement.
  • Experience working with CPT/HCPCs and ICD-10 codes.
  • Experience working with hospital patient accounting systems.
  • Proficiency in MS Office Suite. Including: Excel, Word.
  • Excellent written and verbal communication skills.

Preferred Qualifications:

  • Master's Degree or professional licensure.
  • Medical Coding Certification through the American Academy of Professional Coders (AAPC) and/or the American Health Information Management Association (AHIMA.)
  • Proficiency with MS Access, Visio and/or Power point.
  • Experience reporting from healthcare decision support, patient accounting, contract management and/or claims scrubber systems.
  • Proficiency with visualization software (Tableau, MS Power BI, etc.)

Special Notes: Resume/CV and cover letter should be included with the online application.

Posting Overview: This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date).

If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.

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  • Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.
  • All Hospital positions maybe subject to changes in pass days and shifts as necessary.
  • This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair.
  • This function/position maybe designated as "essential." This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.

Prior to start date, the selected candidate must meet the following requirements:

  • Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicine's Employee Health Services*
  • Complete electronic reference check with a minimum of three (3) professional references.
  • Successfully complete a 5 panel drug screen*
  • Successfully complete a Background Check investigation.
  • Provide a copy of any required New York State license(s)/certificate(s).

Failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.

  • The hiring department will be responsible for any fee incurred for examination.

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Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.

If you need a disability-related accommodation, please call the University Office of Equity and Access at (631)632-6280.

In accordance with the Title II Crime Awareness and Security Act a copy of our crime statistics can be viewed here.

'408059

Keywords: Stony Brook University, Westport , Manager for Patient Accounting Revenue Recovery and Retention, Other , East Setauket, Connecticut

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