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Job Description

Responsibilities will include:

• Facilitates the collection of earned reimbursement, reviewing payor contracts to ensure

contract fees are modeled accurately in the billing system and working with billing staff

to identify variances in actual payment.

• Identifies and implements solutions to problems and issues affecting revenue cycle

functions, working collaboratively with other departments within our healthcare

system, including the MSGs and University Hospital (UH).

• Develops and organizes groups/committees to address issues to improve oversight and

efficiency of the revenue cycle.

• Reviews and tracks payment trends, presents data, makes recommendations for

problem and issue resolution based upon staff findings, and reports findings to

leadership.

• Resolves complex physician professional billing issues in a timely manner.

• Leads and mentors revenue cycle subject matter experts and their supporting teams

within MedBest and the MSGs, ensuring a high level of engagement and productivity.

• Prepares service level metrics and explanatory summaries for leadership.

• Develops MSG standards and procedures for all points of the revenue cycle including,

but not limited to, charge capture, data entry, payment posting, insurance follow up,

collections and denials management.

• Adheres to all department and organization policies, procedures, and best practices.

• Maintains working knowledge of applicable Federal, State, and local laws and

regulations. Monitors billing compliance with all third-party payer regulations.

• Maintains confidentiality in compliance with HIPAA regulations and ensures that

department remains compliant with all relevant regulations.

• Completes other duties as needed and assigned.

We are a company committed to creating diverse and inclusive environments where people can bring their full, authentic selves to work every day. We are an equal opportunity/affirmative action employer that believes everyone matters. Qualified candidates will receive consideration for employment regardless of their race, color, ethnicity, religion, sex (including pregnancy), sexual orientation, gender identity and expression, marital status, national origin, ancestry, genetic factors, age, disability, protected veteran status, military or uniformed service member status, or any other status or characteristic protected by applicable laws, regulations, and ordinances. If you need assistance and/or a reasonable accommodation due to a disability during the application or recruiting process, please send a request to [email protected] learn more about how we collect, keep, and process your private information, please review Insight Global's Workforce Privacy Policy: https://insightglobal.com/workforce-privacy-policy/.

Skills and Requirements

Minimum Qualifications:

• Bachelor’s degree in health administration or related field required

• Candidates must have at least six years of experience within healthcare industry,

including medical reimbursement and insurance for physician practice, hospital or

health system. Position requires at least two years of supervisory experience.

• EPIC experience required, knowledge of other EHR billing systems is advantageous.

• Current, in-depth knowledge of governmental and commercial insurance rules and

regulations is required, including regulatory compliance requirements. Extensive

knowledge of Medicare, Medicaid, Managed Care is required.

• Strong analytical and computer skills are required along with the ability to interpret data

to identify trends or areas for improvement, and present information in a succinct,

actionable manner.

• Requires strong written and verbal communication skills as well as ability to interact and

collaborate effectively with personnel at all levels to expedite revenue cycle processes

while supporting customer service.

• Capacity to manage multiple priorities in a fast-paced environment.