Revenue Performance Specialist - PPSC Billing Center Admin
SMG - Boston/Brighton Area - Revenue Mgmt.
PPSC Billing Center Admin
Bachelor's degree is preferred.
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live. Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, New Jersey, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.
The Revenue Performance Analyst is responsible for analyzing, trending, and supporting revenue activities and performance in an assignment Steward Medical Group market.
Principal Duties & Responsibilities:
* Functions as a content expert for practice pre-bill and denial holds, and complex claim issues in Athena. Demonstrates mastery knowledge of working claims and holds in athenaCollector.
* Utilizing daily hold reports and other analytics tools, identifies areas of opportunity to reduce outstanding AR, surface workflow challenges, and provide education to practices.
* Assists with process assessments of revenue cycle operations in practice areas in an effort to identify process improvement opportunities. Functions as the point of contact for revenue cycle process assessments as assigned.
* Collaborates with appropriate resources to provide guidance and timely responses to practice inquiries about pre-billing holds and denials.
* Assist with working practice holds for identified practices as needed.
* Identifies trends in claim workflow and "touches"; reports operational issues to management for further research and resolution.
* Support Practices and Revenue Performance Managers by:
* Helping to manage projects and initiatives at the market and division level.
* Overseeing follow up of open items from day to day business activity.
* Identifying process gaps and recommending improvement initiatives.
* Works closely with training resources to determine how to prioritize delivery of training, and what methods of training should be used to delivery content effectively.
* Works collaboratively Acress Revenue Cycle, Operations, and IT toward meeting the institutional goal of increasing revenue and decreasing outstanding AR.
Knowledge, Education/Skills and Requirements
* 3-5 years experience in revenue cycle, preferably Physician billing.
* Associate's degree in a related field or equivalent in training and experience. Bachelor's Degree preferred.
* Working knowledge of Microsoft Excel, Word, and Powerpoint.
* Athena experience preferred.
* Ability to effectively communicate with various levels of staff.
Job Status: Full Time
Job Reference #: 54451