Senior Revenue Cycle Specialist

Position Summary:

At Stony Brook Medicine the Senior Revenue Cycle Specialist will act as an operational leader in the Hospitals Business Office to analyze track and pursue the payment of underpaid and denied accounts receivable. Successful candidates will have a bachelors degree and three years healthcare revenue cycle experience or in lieu of degree 5 plus years experience in an Acute Care Hospital Revenue Cycle or Patient Accounting Department resolving hospital Managed Care payment variances and/or denials.

Job Responsibilities may include the following but are not limited to:

• Develops staff work listing logic/strategy and claims resolution work flows.
• Educates and trains new staff regarding departmental and unit policy and procedure including: Managed Care Contracts.
• Monitors work queues and staff productivity to ensure work volumes and staffing are aligned.
• Audits staff work; provide education on best practice.
• Supervises junior staff. Completes employee performance programs and evaluations scheduling and timesheets.
• Analyzes and identifies claim payment issues patterns and root cause; tracks and pursues untimely underpaid and denied accounts.
• Collaborates on denials prevention initiatives.
• Liaises with Managed Care Contracting and Insurance Company Provider Representatives to resolve underpayments and denials.
• Collaborates with the Managed Care Department HIM and Patient Accounting leadership to address payment issues and resolve at risk/high dollar accounts.
• Analyzes new contracts and works with Contract Management system support to troubleshoot contract rates and terms.
• Participates in Joint Operating Calls (JOC) with insurance payers.
• Monitors medical record request correspondence distribution and scanning processes volume and trends.
• Assists in maintaining and creating payer report cards claims tracking and management reporting as requested.
• Assists management reporting and special projects as requested.
  
  

Qualifications:

Required:

• Bachelors degree and three years healthcare revenue cycle experience or
  in lieu of a Degree 5 years of Healthcare Revenue Cycle experience resolving hospital Managed Care payment variances and denials.
• Expert knowledge of Medicare and NY Medicaid Inpatient and Outpatient reimbursement methodologies.
• Expert knowledge of third party reimbursement methodology and associated healthcare claim drivers.
• Expert knowledge of inpatient and outpatient billing requirements (UB04 837i).
• Experience working with CPT HCPCs and ICD10 codes.
• Experience working with Cerner Invision Patient Accounting.
• Proficiency in MS Office Suite. Including: Excel Word.
• Excellent written and verbal communication skills.

Preferred:

• Experience working within Cerner Contract Management Epic or equivalent including experience in validating the configuration and build of contracts.
• 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 PowerPoint.
• Knowledge of SQL or Database Queries.
• Experience reporting from healthcare decision support patient accounting contract management and/or claims scrubber systems.
• Proficiency with SAP Business Objects / Crystal Reports.
• Proficiency with visualization software (Tableau MS Power BI etc.)

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 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 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 may be 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 datethe selected candidate must meet the following requirements:

• Successfully complete preemployment physical examination and obtain medical clearance from Stony Brook Medicines Employee Health Services*
• Complete electronic reference check with a minimum of three (3) professional references.
• Successfully complete a 4panel drug screen*
• Meet Regulatory Requirements for preemployment 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 workingenvironment. 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 disabilityrelated accommodation please call the University Office of Equity and Access at (631)6326280.

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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 $75771 $92364 / year.

The above salary range represents SBUHs 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 candidates 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 fulltime positions ($3400).

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.