Revenue Cycle Specialist - Revenue Recovery and Retention

Stony Brook Medicine
$64,945.00 - $79,169.00 / yr
United States, New York, Stony Brook
Dec 27, 2024
Position Summary At Stony Brook Medicine the Revenue Cycle Specialist will work within the Revenue Recovery and Retention Unit of the hospital's business office to analyze, track and pursue the payment of Managed Care under-paid and denied accounts receivable. Successful candidates will have 3 plus years' experience in an Acute Care Hospital Revenue Cycle or Patient Accounting Department resolving payment variances, submitting non-clinical appeals and collaborating with Revenue Cycle and I.T. departments to optimize Managed Care reimbursement and minimize denials. Duties of an Revenue Cycle Specialist may include the following, but are not limited to: Analyze Managed Care payment variances; track and pursue under-paid and denied accounts. Assist in validating Contract Management system changes including encounter qualifiers and payment rates and methodologies. Assist in educating new staff regarding Managed Care Contracts, CM System and Denials and Appeals process. Provide operational support for Senior Revenue Cycle Specialist as required. Provide analysis and reporting as needed. Qualifications Required: Bachelor's Degree and at least 2 years of healthcare revenue cycle experience. In Lieu of a degree, at least 4 years of healthcare revenue cycle experience. Working knowledge of Medicare and NY Medicaid Inpatient and Outpatient reimbursement methodologies. Working knowledge of third party reimbursement methodology and drivers. Working knowledge of hospital inpatient and outpatient billing requirements (UB-04, 837i). Experience working with CPT, HCPCs and ICD-10 codes. Proficiency with an Acute Care Hospital Contract Management system. Proficiency in Microsoft Office Suite, including Excel, Word. Excellent written and verbal communication skills. Preferred: Bachelor's degree in Accounting, Finance, Health Information Management, Health Administration, Computer Science or related field. Medical Coding Certification through the American Academy of Professional Coders (AAPC) and/or the American Health Information Management Association (AHIMA). Experience in revenue recovery within Cerner Contract Management and Optum Payment Integrity Compass. Experience building contracts and modeling revenue in a Hospital Contract Management System. Experience reporting from healthcare decision support, patient accounting, contract management and/or claims scrubber systems. Experience working with Cerner Invision Patient Accounting. Special Notes: Resume/CV 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. ______________________________________________________________________________________________________________________________________ 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 may be 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 4-panel drug screen* Meet Regulatory Requirements for pre-employment screenings. 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. _____________________________________________________________________________________________________________________________________ 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. Visit our* WHY WORK HERE page to learn about the total rewards we offer. Stony Brook University Hospital, consistent with our shared core values and our intent to achieve excellence, remains dedicated to supporting healthier and more resilient communities, both locally and globally. Anticipated Pay Range: The salary range (or hiring range) for this position is $64,945 - $79,169 / year. The above salary range represents SBUH's good faith and reasonable estimate of the range of possible compensation at the time of posting. The specific salary offer will be based on the candidate's validated years of comparable experience. Any efforts to inflate or misrepresent experience are grounds for disqualification from the application process or termination of employment if hired. Some positions offer annual supplemental pay such as: Location pay for UUP, CSEA & PEF full-time positions ($3,400). Your total compensation goes beyond the number in your paycheck. SBUH provides generous leave, health plans, and a state pension that add to your bottom line. Job Number: 2404170 Official Job Title : TH Instructional Support Associate Job Field : Administrative & Professional (non-Clinical) Primary Location : US-NY-East Setauket Department/Hiring Area : Patient Accounting Schedule : Full-time Shift : Day Shift Shift Hours : 8:30am-5:00pm Pass Days : Sat, Sun Posting Start Date : Dec 27, 2024 Posting End Date : Jan 27, 2025, 4:59:00 AM Salary : $64,945 - $79,169 / year Salary Grade : SL2 SBU Area : Stony Brook University Hospital