Job Abstract

Position Summary

At Stony Brook Medicine the Revenue Cycle Coordinator will lead Patient Financial Services staff working within the Hospital’s Business Office. They will act as senior support to staff pursuing the timely and effective billing and collection of the Hospital’s Accounts Receivable. The Coordinator will work collaboratively with the Unit Supervisor to develop and optimize work flows and work queues, train staff and monitor the unit’s work quality and productivity. They will mentor and train staff and serve as the immediate subject matter expert for staff questions. Successful candidates will have a Bachelor’s Degree and at least 2 years of health care revenue cycle experience. In lieu of a degree, at least 4 years of healthcare revenue cycle experience with a background in claims submission, analysis, follow-up and/or denials appeals and resolution.

Duties of a Revenue Cycle Coordinator may include the following, but are not limited to:

• Prepares and submits complex insurance claims, voids and adjustments.
• Investigates and resolves high dollar and complex claim issues including: claim edits, coding and charging issues and improper payments.
• Follows-up on high dollar and complex rejected or denied claims.
• Processes complex appeals.
• Assists the Supervisor in developing and providing staff training. Including creating work aides and procedure manuals.
• Audits staff work; provides education on best practice.
• Educates staff on payer contracts and billing and regulatory compliance.
• Acts as subject matter expert and a primary point of escalation for staff.
• Provides the Unit Supervisor regular updates on unit status including staffing, payment and denial trends and work flow issues and bottle necks.
• Liaises with clinical, I.T. and Revenue Cycle Departments as well as third parties including billing and follow-up vendors, as required.
• Supports the Hospital/Payer Joint Operating Committee process tracking, reporting and researching issues as required.
• Investigates and accurately updates complex COB issues, including refund request letters, reports, mail, etc.
• Assists in unit staffing, scheduling and employee timesheet review and approval.
• Assists in maintaining unit productivity dashboards.
• Assists in the completion of special projects, as requested.

Qualifications

Required:

• Bachelor’s Degree and at least 2 years of health care revenue cycle experience.
• In lieu of a degree, at least 4 years of healthcare revenue cycle experience with a background in claims analysis, follow-up and/or denials appeals and resolution.
• Working knowledge of Medicare and NY Medicaid Inpatient and Outpatient reimbursement methodologies.
• Working knowledge of hospital inpatient and outpatient billing requirements (UB-04, 837i).
• Knowledge of managed care insurance contracts and reimbursement methodologies.
• Experience working with CPT / HCPCs and ICD-10 codes.
• Excellent written and oral communication skills.
• Proficiency with Microsoft Office Suite.
• Requires effective ability to communicate both in written and oral forms.

Preferred:

• Experience with investigating, reviewing, and following up on rejected/denied insurance claims and/or experience using claims scrubber system.
• Experience billing complex hospital claims including: Medicare Benefits Exhaust, HINN, Interim Billing and Organ Donor.
• Experience with Cerner Invision, Millennium, Soarian or RevElate Patient Accounting Systems.
• Proficiency with an Acute Care Hospital Contract Management System.
• Medical Coding Certification through the American Academy of Professional Coders (AAPC) and/or the American Health Information Management Association (AHIMA).
• Master’s Degree.

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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Visit our WHY WORK HERE page to learn about the total rewards we offer.

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 for this position has been established as $63,000 - $75,000 / year.

The above salary represents SBUH’s good faith and reasonable estimate of the range of possible compensation at the time of posting.

In addition, all UUP positions have an additional ($3,087) for Location Stipend annually,

Your total compensation goes beyond the number in your paycheck. SBUH provides generous leave, health plans, and state pension that add to your bottom line.