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Steward Health Care System Manager, Revenue Management in Westwood, Massachusetts

Job Summary:

This position is responsible for providing leadership and subject matter expertise relative to forecasting, calculating and capturing all net revenue contractually owed by the payers.

Responsibilities:

  • Independently manage and monitor daily work related to identifying net revenue contractually owed.

  • Experience with a contract management tool to manage contract inventories and simply the reimbursement process by calculating expected payments.

  • Experience interpreting managed and commercial payer contract language, state/federal payer regulations and how it relates to pricing claims.

  • Understand the process to identify, research and resolve over/under payments.

  • Manage the daily operations the revenue integrity unit including productivity, quality, hours-worked, development needs and other aspects of employee/team performance.

  • Assist in the evaluation and recommendations of programs, procedures for improved operations, modifications to and/or implementation of new procedures.

  • Identify and work with the director to resolve problems with CBO processes and when appropriate, initiate changes to prevent future problems.

  • Assist in establishing long and short term unit goals and objectives to support department and corporate strategic plan.

  • Maintain professional competency, according to department policies, procedures and protocols.

  • Maintain a repository of knowledge required to train new revenue cycle associates including manuals, tip sheets and other materials.

  • Maintain strict confidentiality and adheres to all HIPAA guidelines/regulations.

Qualifications:

  • Associate's degree required; Bachelors preferred.

  • 4 years minimum experience in hospital billing with specific payer(s) subject matter expertise.

  • Demonstrated ability to manage teams or groups of colleagues.

  • Experience with patient accounting systems, billing/claim submission software required.

  • Specific XClaim and/or Meditech experience a plus.

  • Possess ability to investigate, analyze and in coordination with management, resolve departmental issues.

  • Possess ability to work efficiently and accurately, and to organize and plan work.

  • Possess flexibility and adaptability to work additional hours and to work under stress.

  • Ability to establish and maintain effective working relationships and communicate clearly with customers both within and outside of Steward.

  • Highly detail oriented and well organized; ability to multitask.

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