Job Description
Location: Steward Health Care
Posted Date: 3/11/2021
PRIMARY RESPONSIBILITIES:
* Ability to read, interpret and apply modeling logic within Contract Modeling software accurately.
* Acute knowledge of charging, billing and payer reimbursement and ability to identify underpayments.
* Identify, through auditing of system functionality and operational assessment, underpayments that are a result of operations and incorrect system specifications
* Extensive knowledge and ability to analyze reimbursement, claims details for identification of opportunities
* Ability to manage projects for recovery, including retrospective analysis, reimbursement quantification and tracking, organizational skills to lead various teams to implement and perform required steps for recovery
* Detailed knowledge of payer contracts and reimbursement policies.
SKILL OR EXPERIENCE REQUIREMENTS:
* Minimum 8 years prior hospital revenue cycle experience required
* Minimum 8 years' experience with Hospital Contract and/or Financial Modeling, perferred
* Managed Care Knowledge and understanding of various hospital payment methodologies both commercial and government.
* Microsoft Office proficiency required.
* Ability to communicate clearly and effectively
* Solid competencies in assessment and critical thinking
EDUCATION OR SPECIFIC TRAINING REQUIREMENTS:
Undergraduate degree or equivalent combination of education and work experience.
ADDITIONAL SKILLS NEEDED:
Organization & Time Management
Hospital Business Office Experience Preferred
Boston, MA
What Should I Know About Carney Hospital?
Carney Hospital in Dorchester, Massachusetts, has proudly served the City of Boston and neighboring communities since 1863.
Since 1863, Carney Hospital has served the City of Boston and neighboring communities. Carney Hospital has received the Joint Commission’s Gold Seal of Approval for health care quality and safety and numerous other quality and safety awards, including being designated a Top Hospital for 2014, 2015 and 2017 by the Leapfrog Group. The 159-bed hospital has more than 400 physicians and delivers high-quality to our community where they live. Carney Hospital provides Dorchester and surrounding communities with convenient, local access to quality primary care, emergency medicine and a range of specialties and subspecialties including; critical care, family medicine, cardiology, neurology, orthopedics, ambulatory care and adolescent, adult and geriatric psychiatry.
Carney Hospital operates a stand-alone Emergency Room located in the city of Quincy with on-site diagnostic radiology, including CT scans and ultrasound, pharmacy, and laboratory services. Carney Hospital is part of the Steward Health Care Network.
Carney Hospital is a Steward Family Hospital. Steward Health Care is the largest private, tax-paying physician-led health care network in the United States. Headquartered in Dallas, Texas, Steward operates 37 hospitals in the United States and the country of Malta that regularly receive top awards for quality and safety. The company employs approximately 42,000 health care professionals. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, over 7,900 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.