Revenue Recovery Specialist, Outpatient Billing

$48,709 - $59,376/Yr

Stony Brook University - East Setauket, NY

Full-time - Entry Level

East Setauket, NY

Educational Services

About the position

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.

Responsibilities

• 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.

Requirements

• 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.

Nice-to-haves

• 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.

Benefits

• Generous leave
• Health plans
• State pension
• Location pay for UUP, CSEA & PEF full-time positions ($3,400)