Job Description
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live. Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.
Position Summary:
This position is responsible for providing trending and expert level root cause analysis in active and closed accounts receivable. The AR Analyst acts as an additional training and quality support for the Accounts Receivable teams and a resource for the Revenue Performance Managers (RPM) and Practices to proactively report out on actionable claims denials, process breakdowns, and payor nuances impacting office and financial behaviors.
Key Responsibilities:
Review workflow dashboards and AR aging reports with the assigned divisional RPMs to identify trends that impact the practice and back office financial performance
Leading weekly and/or monthly calls with divisional RPMs to discuss trends and accurately and completely document all communications, trainings and other transactions between the RPMs and AR
Provides training related to SMG CBO policies and procedures to RPMs and other Accounts Receivable staff
Independently manage and monitor own daily work related to resolution of third-party payer accounts receivable follow-up, billing and re-billing and favorable resolution of denials and underpayments
Provide subject matter expertise regarding specific payors to revenue cycle associates and others throughout the CBO in accounts receivable follow-up, billing, denials and/or underpayments.
Assist in the evaluation and recommendations of programs, procedures for improved operations, modifications to and/or implementation of new procedures.
Identify and work with leads and management to resolve problems in CBO processes and when appropriate, initiate changes to prevent future problems
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.
Required Experience & Skills:
High School Diploma or equivalent required; Associates Degree preferred.
2 years minimum experience in provider billing with specific payor(s) subject matter expertise.
Experience with patient accounting systems, billing/claim submission software required.
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.
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.
Additional Information
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.
1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
2. A stringent cleaning policy has been implemented throughout our facilities.
3. A strictly controlled visitor and mask policy is required for patient and colleague safety.
Steward Health Care System LLC ("Steward") is a fully integrated, physician-led national health care services organization committed to providing the highest quality of care in the most cost-efficient manner in the communities where our patients live. Steward - the largest privately held health care company in the U.S. - owns and operates 35 community hospitals across nine states, serves over 1,000 distinct communities and employs approximately 40,000 health care professionals. In addition to our hospitals, the Steward provider network includes 4,800 providers, 25 urgent care centers, 87 preferred skilled nursing facilities, substantial behavioral health offerings, over 7,300 hospital beds under management, and approximately 1.5 million full risk covered lives through the company's managed care and health insurance services.
Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.