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Operations Reconciliation Analyst
- Nuvance Health (Poughkeepsie, NY)
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*Description*
*Summary:*
This position will partner with all Nuvance Health Medical Practices to identify opportunity, and support revenue recovery initiatives and process improvement.
*Responsibilities:*
1. Manages and analyzes front end reports to quantify and resolve front end edits
2. Serve as a subject matter expert related to charging and billing issues, and assists in developing and maintaining related policies, procedures, and work flows
3. Performs daily reconciliation of professional charges through review of service line schedules, orders, completed physician documentation, and associated charge line items to capture and remediate unbilled charges
4. Provides guidance, communication and education regarding correct charge capture and billing processes to multiple clinical departments and facilities
5. Supports Practice Management through biweekly question and answer sessions
6. Works closely with department managers and operational leaders in addressing front end processes and work queue edits, identifying process improvement opportunities
7. Works closely with Patient Accounting to ensure all billing edits and coding edits are corrected within Revenue Cycle, where applicable
8. Works with Coding Departments, Registration areas and Information Technology Services to ensure proper setup of new service line work queues specific to front end, and billing
9. Partners with the Coding Department upon identification of unbilled surgical charges
10. Manages and remediates Suspended Charges
11. Maintains and Model Nuvance Health Values and Code of Conduct
12. Leads and participates in moderately complex projects related to revenue cycle initiatives
13. Actively participates in all Revenue Cycle related special projects as well as daily, monthly and yearly reporting
14. Stays current with regulatory revisions in payment methodologies via seminars, websites, etc
15. Demonstrates regular, reliable and predictable attendance
16. Maintain and Model Nuvance Health Foundational Values (Personal, Imaginative, Agile, Connected)
17. Performs other duties as required.
Education: BACHELOR'S LVL DGRE
*Other Information:*
• Bachelor’s Degree or equivalent experience
• Certified Professional Coder (CPC) preferred
•Five (5) years relevant experience in hospital setting, clinic setting, or insurance company with revenue cycle experience
• Detailed oriented
• Proficient in Microsoft Office – specifically Excel and PowerPoint
• Strong analytic aptitude
• Excellent project management skills
• Possesses strong interpersonal communication and presentation skills, effectively presenting information to executives, management, providers, facility groups, and individuals
• Understands expectations of patients, payors, and employees and how those expectations relate to complete, timely, and accurate work products
Certified Professional Coder (CPC) HFMA Certified Revenue Cycle Representative Certification (CRCR) or Certified Healthcare Financial Professional (CHFP) Certification preferred.
*Working Conditions:*
Manual: significant manual skills/motor coord & finger dexterity
Occupational: Little or no potential for occupational risk
Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force
Physical Environment: Generally pleasant working conditions
Company: Nuvance Health
Org Unit: 1826
Department: Patient Accounting Med Practic
Exempt: Yes
Salary Range: $25.70 - $47.72 Hourly
We are an equal opportunity employer
Qualified applicants are considered for positions and are evaluated without regard to mental or physical disability, race, color, religion, gender, national origin, age, genetic information, military or veteran status, sexual orientation, marital status or any other classification protected under applicable Federal, State or Local law.
We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation or our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to ensure that you are considered for current or future opportunities.
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