JOB SUMMARY Monitor reports for a single hospital that drive SLA/KPI.
Identify trends, facilitate implement solutions to ensure client satisfaction.
Owns reporting and provides support to CFO.
ESSENTIAL DUTIES AND RESPONSIBILITIES Include the following.
Others may be assigned. - Customer Service (phone, mail and/or e mail) – point of escalation.
Work with hospital leadership and departments to resolve revenue cycle issues.
(e.g., orders, charging, Patient Access, DNFB, DNSP, QS, disputes)
- Responsible for the review/adjudication of Revenue Reclasses, Adjustments, Refunds, Charity Applications and Professional Courtesy Discounts
- Monitor/review billing, A/R and reconciliation for hospital specific contracts (e.g., non-IMaCs, local employer).
Monitor/analyze AR/Disputes and assists with Bad Debt Initiatives.
Responsible for the analysis of eReserve and items/trends that significantly impact net revenue.
-Support/Coordinate/Monitor the following: Department Head meetings, Chart Audit meet Compliance Committees, Charge Master review/updates, pass through invoice retrieval, Complex (e.g., 'High $" or "At-Risk") in-house patient meetings, Hospital Revenue Cycle Implementation Initiatives, Internal/External Audit Assistance, Engaging Legal for Collection Issues
-Review proposed managed care contracts and identify any issues or concerns with implementation of the terms prior to the contract being finalized.
Assist in analyzing data to verify contract terms have been loaded correctly into IMaCs and claims properly adjudicated during and after managed care negotiations
- Monitor and communicate non-reimbursable charges (e.g., ABN not signed, denials, disputes, bad debt)
- Responsible for preparation and completion of eReserve
Qualifications MINIMUM EDUCATION: Bachelor's Degree in Business, Health Administration or other related field from an accredited college or university.
MINIMUM EXPERIENCE: 3 or more years in A/R Management and/or Managed Care contracting and analysis with experience directing a multi-facility business office
KNOWLEDGE, SKILLS, ABILITIES To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Analytical Skills AR Management experience to include contract adjudication knowledge Strong Leadership Effective Communication Computer/IT/System experience Experience with the A/R process flow Regulatory/Compliance experience Champions the hospital's interest #LI-MXJ1
Tenet complies with federal, state, and/or local laws regarding mandatory vaccination of its workforce.
If you are offered this position and must be vaccinated under any applicable law, you will be required to show proof of full vaccination or obtain an approval of a religious or medical exemption prior to your start date.
If you receive an exemption from the vaccination requirement, you will be required to submit to regular testing in accordance with the law.
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