| Job Overview: The major responsibility of this position will be to identify payment variances at the account level based on expected reimbursement from contracted managed care payers, governmental payers and non-contracted miscellaneous payers. Knowledge and experience with revenue cycle, including the billing, follow up and payment processes, will be critical for success in this role, as well as experience with payer contract language and various payment methodologies. Knowledge of the Patient Access and/or HIM functions would also be helpful. Critical thinking skills, as well as the ability to identify trends and/or process improvement opportunities will be expected. This position will be the contract language expert for our many payers. To perform this role, working knowledge of various billing and payers systems will be required, as well as the ability to compare, analyze and communicate trends and/or problems is essential. This is a working position, meaning accounts identified to have a contract variance will be worked until payment as expected is received. Job Requirements: Associate's Degree or Diploma in Business, Healthcare, or other related field Equivalent experience accepted in lieu of degree Working knowledge of Epic Resolute, Excel, understanding of managed care contracts and payment terms 3-4 years experience Professional Healthcare Revenue Cycle Billing and Follow Up experience Patient Access and/or HIM knowledge Experience Management Healthcare Job Responsibilities: Other job-related information: Work Environment: Requires eye-hand coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator and other office equipment Requires normal range of hearing and eyesight to record, prepare and communicate appropriate reports Requires lifting papers or boxes up to 25 pounds occasionally Work is performed in an office environment. Contact may involve dealing with angry or upset people Staff must remain flexible and available to provide staffing assistance for any/all disaster or emergency situations Able to effectively manage exposure to potentially infectious material per OSHA guidelines Working Conditions: Climbing - Rarely Concentrating - Consistently Continous Learning - Frequently Hearing: Conversation - Consistently Interpersonal Communication - Consistently Kneeling - Occasionally Lifting <10 Lbs - Frequently Lifting 50+ Lbs - Rarely Lifting 11-50 Lbs - Occasionally Pulling - Rarely Pushing - Rarely Reaching - Rarely Reading - Consistently Sitting - Frequently Standing - Frequently Stooping - Rarely Thinking/Reasoning - Consistently Use of Hands - Consistently Color Vision - Frequently Walking - Frequently TriHealth SERVE Standards and ALWAYS Behaviors At TriHealth, we believe there is no responsibility more important than to SERVE our patients, our communities, and our fellow team members. To achieve our vision and mission, ALL TriHealth team members are expected to demonstrate and live the following: Serve: ALWAYS… • Welcome everyone by making eye contact, greeting with a smile, and saying "hello" • Acknowledge when patients/guests are lost and escort them to their destination or find someone who can assist • Refrain from using cell phones for personal reasons in public spaces or patient care areas Excel: ALWAYS… • Recognize and take personal responsibility to address and recover from service breakdowns when a customer's expectations have not been met • Offer patients and guests priority when waiting (lines, elevators) • Work on improving quality, safety, and service Respect: ALWAYS… • Respect cultural and spiritual differences and honor individual preferences. • Respect everyone’s opinion and contribution, regardless of title/role. • Speak positively about my team members and other departments in front of patients and guests. Value: ALWAYS… • Value the time of others by striving to be on time, prepared and actively participating. • Pick up trash, ensuring the physical environment is clean and safe. • Be a good steward of our resources, using supplies and equipment efficiently and effectively, and will look for ways to avoid waste. Engage: ALWAYS… • Acknowledge wins and frequently thank team members and others for contributions. • Show courtesy and compassion with customers, team members and the community |
