Senior Revenue Cycle Specialist - Research Billing - 2101278
At Stony Brook Medicine, the Senior Revenue Cycle Specialist in this area will work to audit, reconcile, bill and follow up on the collection of research billing. The Senior Specialist will work to ensure the hospital's compliance with appropriately differentiating and billing those services provided under research study or clinical trial from those billable to insurance under routine standards of care. Acting as auditor, biller and collector, the Senior Revenue Specialist will collaborate closely with protocol reviewers, study coordinators, insurance billers and business managers in the hospital's Cancer Center, Revenue Cycle Management, Patient Accounting and Research departments. Successful candidates will have 5 plus years' experience in a claims analysis, billing and/or resolution role for an Acute Care Hospital Revenue Cycle or Patient Accounting Department. Experience reviewing research budgets and auditing, billing and following up on research claims for an academic medical center preferred.
Duties of a Senior Revenue Cycle Specialist may include the following but are not limited to:
Audits research billing CPT coding and charging against approved study budgets to ensure billed research procedures/charges are appropriate.
Liaise with protocol reviewers, study coordinators and patient accounting insurance billing staff to resolve questions including standard of care and research charges.
Move and reconcile charges and coordinate the creation of patient encounters as required.
Support billing charges at the agreed upon fee schedule. This may include working with technical support to load fee schedules to the patient accounting system; mapping study budgeted services to hospital charge codes and manually netting paper billing and posting allowances to the billing system.
Follow up with study coordinators and business managers to collect on unpaid and underpaid accounts.
Monitor research billing A/R to ensure accurate, complete and timely billing; report and escalate any exceptions to Business Office Management.
Track, trend and report billing status and outcomes to Patient Accounting and Research Departments as requested.
Develop, configure and support software systems and automation tools which optimize and evolve the research billing function.
B.S. Accounting/Finance, Health Information Management, Health Administration, Computer Science or related field and 5+ Years Healthcare Revenue Cycle experience analyzing, billing and/or resolving hospital claims OR in Lieu of a Degree 7+years Healthcare Revenue Cycle experience.
Experience working within a Hospital Patient Accounting system such as Cerner/Siemens, Epic,
CPSI or Medhost.
Experience working with CPT/HCPCs and ICD-10 codes.
Working knowledge of inpatient and outpatient billing requirements and compliance (UB-04, 837i)
Knowledge of Medicare, Medicaid and third party reimbursement methodologies.
Proficiency in MS Office Suite. Including: Excel, Word.
Excellent written and verbal communication skills.
Experience reviewing research budgets and auditing, billing and following up on research claims for an academic medical center.
Medical Coding Certification through the American Academy of Professional Coders (AAPC) and/or the American Health Information Management Association (AHIMA.)
Experience as a Financial or Business Analyst supporting Healthcare Revenue Cycle operations.
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.
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.
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.
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Official Job Title: TH Patient Accounting Specialist
Job Field: Finance
Primary Location: US-NY-East Setauket
Department/Hiring Area: Patient Accounts-Stony Brook University Hospital
Schedule: Full-time Shift: Day Shift Shift Hours: 8:30am-5:00pm Pass Days: Sat, Sun
Posting Start Date: Apr 22, 2021
Posting End Date: Jul 22, 2021, 3:59:00 AM
Salary: Commensurate with experience
Salary Grade: SL3
Internal Number: 2101278
About Stony Brook University
FROM ITS BEGINNINGS A HALF-CENTURY AGO, STONY BROOK UNIVERSITY HAS BEEN CHARACTERIZED by innovation, energy and progress, transforming the lives of people who earn degrees, work and make groundbreaking discoveries here. A dramatic trajectory of growth has turned what was once a small teacher preparation college into an internationally recognized research institution that is changing the world.