Revenue Recovery Specialist, Outpatient Billing

Revenue Recovery Specialist, Outpatient Billing

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Position Summary

At Stony Brook Medicine, a Revenue Recovery Specialist will provide operational support within the Hospital’s Patient Accounting Department. The position will support day-to-day business functions including but not limited to: denied claims analysis, appeals and follow-up.

Duties of a Revenue Recovery Specialist may include, but are not limited to the following:

• Follow-up on rejected or denied claims, improper payments and coding issues leveraging managed care contracts to ensure optimal reimbursement.
• Identify issues and patterns with claims/insurance companies and review to increase revenue and prevent unnecessary denials.
• Investigate and accurately update COB, including refund request letters, reports, mail, etc.
• Document work activity in computer systems and set appropriate follow up.
• Effectively manage and prioritize work portfolio to ensure timely processing and resolution of accounts.
• Liaise with Care Management, HIM, and Revenue Integrity departments to facilitate appeals and denial resolution.
• Other duties as assigned.

Qualifications

Required Qualifications:

• Associates Degree and at least 6 months of health care revenue cycle, medical billing, or follow-up experience.
  In lieu of degree, at least 2 years of revenue cycle, medical billing or follow-up experience.
• Excellent written and oral communication skills.
• Proficiency with Microsoft Office.

Preferred Qualifications:

• Experience investigating, reviewing and following-up on rejected/denied inpatient and outpatient hospital claims.
• Experience with Inpatient and Outpatient billing requirements (UB04/837i) and/or CMS Medicare and New York Medicaid reimbursement methodologies.
• Knowledge of third-party payer reimbursement and managed care contracts.
• Knowledge of CPT, HCPCs and ICD-10 coding principles.
• Experience with Cerner Invision, Soarian or Millennium Patient Accounting.
• Experience in Insurance Verification.
• Experience working in Medicare FSS DDE System.

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.

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• 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 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.

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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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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 $48,709 - $59,376 / 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.