Position Summary At Stony Brook Medicine, a Revenue 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: billing, claims analysis appeals, follow-up, financial assistance and customer service. Duties of a Revenue Specialist may include the following, but are not limited to:
- Prepare and submit hospital claims. Review denials. Investigate coding issue. Audits.
- Follow-up on rejected or denied claims, improper payments and coding issues.
- Process appeals.
- Liaise with third party billing and collection agencies.
- Identify issues and patterns with claims/insurance companies and review to increase revenue and prevent unnecessary denials.
- Assist the supervisor in scheduling, timesheet, leave requests, performance programs and evaluations.
- Assist the supervisor in training and make recommendation to improve policy and procedures for the unit as well as the office.
- Investigate and accurately update COB, including refund request letters, reports, mail, etc.
- Other duties as assigned.
Qualifications Required Qualifications
- Bachelor's degree in Accounting, Business, Health Information Management or related field with a minimum of 6 months business experience, preferably in a healthcare setting; or an Associate's degree and at least 6 months of business experience, preferably in a healthcare setting such as revenue cycle, medical billing, or follow-up experience; or in lieu of degree, at least 2 years of business experience, preferably in a healthcare setting such as revenue cycle, medical billing, or follow-up experience.
- Excellent written and oral communication skills.
- Proficiency with Microsoft Office.
- Has in depth knowledge and experience with investigating, reviewing, and following up on rejected/denied insurance claims and/or experience using claims scrubber system.
Preferred Qualifications
- Experience with Inpatient and Outpatient billing requirements (UB-04/837i) and/or CMS Medicare and New York Medicaid reimbursement methodologies.
- Knowledge of third party payer reimbursement and managed care contracts.
- Experience investigating, reviewing and following-up on rejected/denied inpatient and outpatient hospital claims.
- Knowledge of CPT, HCPCs and ICD-10 coding principles.
- Experience with Cerner Invision and/or Cerner 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.
- 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. 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)###-####. In accordance with the Title II Crime Awareness and Security Act a copy of our crime statistics can be viewedhere. Visit ourWHY 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.