Job Description

Location: Steward Health Care
Posted Date: 6/7/2022

POSITION SUMMARY:

Responsible for all aspects of the revenue cycle for the Steward Health Care System hospitals. Reports to the SVP - Finance & CFO.

KEY RESPONSIBILITIES:

Responsible for the following revenue cycle components:

  • Patient Financial Services. Responsible for the following:
    • Continue process of building a world class CBO in Richardson, TX
    • All billing, collections and accounts receivable management.
    • All denials management.
    • Coordinate all payer communications regarding appeals, denials, etc. with Chief Managed Care Officer

  • Patient Access. Responsible for the following:
    • Centralized scheduling
    • Insurance verification and approvals
    • Admitting and outpatient registration
    • Copay collections

  • Health Information Management. Responsible for the following:
    • All medical records, transcription and coding.
    • Follow-up of certain types of denials.
    • Monitoring and enforcement of completion of records by physicians.
    • Monitoring and enforcement of coding by clinical departments.

  • Fiscal & Clinical Integration. Responsible for increasing net revenue by uncovering and resolving revenue issues ranging from coding to charge capture to case management. Responsible for defending the hospitals’ interests on all third party payer audits.

  • Payment Verification & Charge Master. Responsible for the following:
    • Verification of payments from all payers to ensure compliance with contracts.
    • Collection of all underpayments.
    • Management of charge master for all hospitals, including rate sensitivity analyses for all hospitals at least annually and frequent monitoring of “lower of cost or charge” issues.

  • Along with the Chief Managed Care Officer, responsible for working with third party payers with respect to all level-of-care and length-of-stay issues.

  • Third Party Reimbursement. Responsible for the following:
    • Manage all governmental payer relationships (Medicare & Medicaid), including the filing of all cost reports and rate filings.
    • Calculate annual net revenue budgets for all hospitals.
    • Ensure integrity of net revenue monthly for all hospitals.
    • Perform continuous net revenue analysis by payer for each hospital.
    • Manage third party reserves for all six hospitals, including all prior period adjustments and all PRRB appeals.
  • All other duties and responsibilities as assigned from time to time by the CFO and/or SHCS ELT.

REQUIRED KNOWLEDGE & SKILLS:

  1. Possesses strong analytic and technical skills, including a strong foundation of developing dashboards presenting key revenue cycle and A/R metrics on a daily basis.
  2. Organizational skills to manage multiple projects through effective planning and time management.
  3. Knowledge of Meditech revenue cycle systems.
  4. Sound verbal and written communication skills; outstanding interpersonal skills; ability to relate positively with hospital operations and ELT.
  5. Participates in projects and attends other team meetings as assigned.
  6. Creative, flexible, and self-motivated with sound judgment; ability to plan and implement.
  7. Commitment to service excellence.

EDUCATION/EXPERIENCE/LICENSURE/TECHNICAL/OTHER:

  1. Education: Bachelor's degree in relevant required, Master’s preferred.
  2. Experience (Type & Length): Minimum of ten years’ experience in healthcare, with significant experience in hospital revenue cycle functions.
  3. Hardware/Software: MS Office (Excel, Word, PPT), Access, SQL, and/or other query/analytic tools.

Application Instructions

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