"Revenue Specialist"

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 and 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:

• 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 in lieu of a Bachelor's degree, 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 college 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.

Preferred:

• Experience investigating, reviewing, and following up on rejected, denied insurance claims and/or experience using claims scrubber systems.
• 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 or 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.

Please Note: Verification of degree (e.g., diploma or official transcript) is required for this role. Upload of documentation must be included with your application for consideration.

Special Notes: Resume/CV should be included with the online application.

Anticipated Pay Range: The salary range (or hiring range) for this position is $49,683 - $60,564 / year.