Payment Variance Specialist
This position is responsible for Steward Medical Group follow up operations, meeting goals and company objectives, in assigned areas of patient/insurance credit balances,underpayments, collections, payment validation, customer service and correspondence using the Athena web system. Associate must ensure that all process meet all government mandated procedures for integrity and compliance. Performs all responsibilities in a prompt and efficient manner. Must be detail oriented meeting multiple deadlines while working independently and/or in small groups. Revenue Cycle Payment Variance Specialist knowledge is required and Athena experience is preferred. The Payment Variance Specialist reports to the Payer Intelligence Supervisor or Manager
- Process refunds for patient and insurance for all markets in Athena
- Analyze patient account to determine true credit balances
- Initiate patient refunds via Athena interface
- Initiate AR followup team payer refunds and Vendor patient/insurance refunds manually via RDU file creation
- Verify AR payer refund backup
- Upload RDU files to Cognizant via Catalyst
- Cognizant reporting in Catalyst to balance with Refund A
- Work Exceptions in Catalyst
- Create refund Payment Proposals
- Submit signed Payment Proposals to Treasury
- Enter patient refund check numbers into Athena
- Returned checks – Bad Address research addresses Meditech/Athena and update in system
- Mail Vendor payer refund checks to the vendor for mailing to payers with backup
- Mail Athena payer refund checks with all corresponding backup to appropriate address
- Follow the Abandoned Property process
- Run reports weekly related to refunds
- Maintains strict confidentiality and adheres to all HIPAA guidelines/regulations
REQUIRED KNOWLEDGE & SKILLS:
- High school diploma or equivalent required. Associates degree preferred.
- 2-3 years experience with medical billing/collection; physician billing experience preferred.
- 2-3 years expericece with Revenue Cycle Payment Variances including patient/insurance credit balances,underpayments, initiation of refunds, reconciliation and EOB interpretation
- Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus
- Experience with patient accounting, contract management systems and billing/claim submission software; specific Athena Health experience a plus
- Knowledge of revenue cycle and/or business office procedures.
- Ability to utilize basic Microsoft Office programs
- Moderate to advance level of excel knowledge-including pivot tables
- Highly detail oriented and well organized
- Ability to read, understand and follow oral and written instructions
- Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of Steward
Steward Health Care is the largest private, for-profit health care network in the United States. The company is owned and led by a management team of Steward physicians. Headquartered in Dallas, Texas, Steward employs more than 40,000 health care professionals and operates 35 hospitals across the United States and in the countries of Malta and Colombia which regularly receive top awards for quality and safety. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, more than 7,000 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.
The Steward Health Care Network includes more than 5,000 physicians across 800 communities who help to provide more than 12 million patient encounters annually. Steward Medical Group, the company's employed physician group, provides more than six million patient encounters per year. The Steward Hospital Group operates hospitals in Malta, Colombia and nine states across the U.S., including Arizona, Arkansas, Florida, Louisiana, Massachusetts, Ohio, Pennsylvania, Texas, and Utah. For more information, visit www.steward.org.
Steward Health Care is an Equal Employment Opportunity (EEO) employer, Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.
Steward Medical Group is taking additional necessary preparations to ensure patients can receive compassionate care in safe, carefully managed environment – with confidence and without fear.
Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience.
- Any COVID-19 related care takes place in designated areas away from other patients and their families.
- A stringent cleaning policy has been implemented throughout our facilities.
- A strictly controlled visitor and mask policy is required for patient and colleague safety.