Revenue Recovery Consultant

HHC

2d • Onsite

About The Position

Eskenazi Health serves as the public hospital division of the Health & Hospital Corporation of Marion County. Physicians provide a comprehensive range of primary and specialty care services at the 333-bed hospital and outpatient facilities both on and off of the Eskenazi Health downtown campus including at a network of Eskenazi Health Center sites located throughout Indianapolis. The Revenue Recovery Consultant is responsible for monitoring, analyzing, and trending government, managed care, and commercial payer hospital and outpatient hospital-based patient claim payment variances in order to optimize revenue recovery, assess contract compliance, and communicate contract and reimbursement issues to management.

Requirements

• Bachelor’s degree in finance, business, or healthcare related field required. In lieu of bachelor’s degree, minimum of 5 years relevant experience required
• Minimum of 3 years Revenue Cycle experience
• Minimum of two years’ analytics experience preferred
• Minimum of two years denial appeal process preferred
• Revenue Cycle billing experience preferred
• Knowledge of inpatient and outpatient coding and billing
• Advanced problem-solving, analytical and critical thinking skills
• Working knowledge of Joint Commission (JC), Indiana State Department of Health (ISDH) and Centers for Medicare and Medicaid Services (CMS) regulations as they relate to medical documentation and health information management
• Ability to work effectively with all levels of the organization, including physicians
• Knowledge of clinical documentation management tools and techniques
• Strong written and verbal communication skills
• Strong positive attitude; competent interpersonal skills
• Demonstrated leadership skills and strong organizational skills
• Ability to work independently; motivated to produce high quality outcomes

Nice To Haves

• Project Management Professional (PMP) certification and/or Lean Six Sigma certification strongly preferred
• Working knowledge of various software applications including EPIC and Excel preferred

Responsibilities

• Perform a variety of tasks related to developing a knowledge-base and understanding of government payer regulations, terms of third-party payer regulations and contracts, coverage and benefit plans, coordination of benefits, code assignment, payment terms and all other conditions affecting payment, appeal of payment variances and correct payment calculation.
• Use internal data and systems to identify, document, track and summarize payment variances to determine appropriate actions to be taken to initiate appeals and to address inaccurate reimbursement in a timely manner.
• Analyze internal processes, technical system issues and payer processing/system issues and determine/communicate corrective actions to resolve payment variances.
• Document cost savings and revenue recovered through various projects, workflow improvements, and analyses.
• Must act as a change agent within the organization on current processes to improve process workflows.
• Works collaboratively with internal and external customers to ensure accurate and compliant documentation and utilization of resources.
• Partner with Decision Support Analytics to identify, trend, and work with Revenue Cycle departments on improvement work related to the reduction of denials and write-offs.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level