Revenue Recovery Specialist: Reimbursement Team, Days

4 weeks ago


Columbia, United States University of Missouri Full time

HOURS: Monday through Friday 8:00 AM to 4:00 PM

DEPARTMENT: Patient Financial Services

WORK LOCATION: Onsite or Remote work available. Opportunity to work remote - Remote staff are required to come on site once approximately every 5 weeks.

SALARY: $22.00 - $34.74/HR

ABOUT MU HEALTH CARE

MU Health Care is a growing academic health system in mid-Missouri comprised of multiple hospitals - including the region's only Level 1 Trauma Center and region's only Children's Hospital - and over 50 specialty clinics located throughout the region.

As an MU Health Care employee, you'll be part of an exceptional team committed to our mission of saving and improving lives. Our core values of inclusion, respect, service, discovery, responsibility and excellence foster a collaborative work environment where you can grow your career.

Learn more about MU Health Care. Learn more about living in Columbia, MO.

BASIC FUNCTION AND RESPONSIBILITY

To monitor, analyze, and appeal 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.

CHARACTERISTIC DUTIES

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, payment terms and all other conditions affecting payment, appeal of payment variances and correct payment calculation.

Perform a variety of tasks related to use of internal data and systems to identify, document, track and summarize payment variances to determine appropriate actions to be taken so as to initiate appeals and to address inaccurate reimbursement in a timely manner.

Perform a variety of tasks to analyze internal processes, technical system issues and payer processing/system issues and to determine/communicate corrective actions in order to resolve payment variances.

Perform a variety of tasks, in conjunction with Managed Care Contracting and Government Payers Department staff, to achieve most accurate payer and contract modeling in the decision support system.

Perform a variety of tasks to document appeals of payment variances and reimbursement amounts recovered thru the various appeals processes.

Perform special projects, as assigned, in order to resolve recovery issues, settlements with payers and optimize revenue recovery.

SUPERVISION RECEIVED

Administrative supervision is received from the Supervisor, Revenue Management.

SUPERVISION EXERCISED

None

EMPLOYEE BENEFITS

* Health, vision and dental insurance coverage starting day one * Generous paid leave and paid time off, including nine holidays * Multiple retirement options, including 100% matching up to 8% and full vesting in three years * Tuition assistance for employees (75%) and immediate family members (50%) * Discounts on cell phone plans, rental cars, gyms, hotels and more

See a comprehensive list of benefits here.

QUALIFICATIONS

A bachelor's degree in Accounting, Business Administration, Finance, Health Related Professions, Nursing or an equivalent combination of education and experience from which comparable knowledge and abilities can be obtained is required.

Minimum of three years experience in business acumen, insurance or managed care industry, hospital patient accounts or a related health-care area such as utilization management, case management or hospital audit and reimbursement is required.

Experience in health related contractual analysis involving rate and language analysis, audit and reimbursement, claims denial and appeals experience is preferred.

Knowledge of or willingness to learn fundamentals of coding CPT/HCPCS, ICD-9 and/or ICD-10, DRG's and APC's is perferred.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met with or without reasonable accommodation. The performance of these physical demands is an essential function of the job. The employee may be required ambulate, remain in a stationary position and position self to reach and/or move objects above the shoulders and below the knees. The employee may be required to move objects up to 10 lbs.

PERFORMANCE EXPECTATIONS

This job description is not designed to cover or contain a comprehensive listing of activates, duties or responsibilities that are required of the employee for this job; however, completion of these duties is a measure of successful performance. Employees of this job classification are subject to quarterly performance reviews. Basic function, responsibilities and characteristics duties may change at any time with or without notice.


  • Recovery Specialist

    4 weeks ago


    Columbia, United States APEX Recovery Rehab Full time

    Job DescriptionJob DescriptionAPEX Recovery LLC, an innovative and integrative treatment center, has an exciting career opportunity for individuals with addiction treatment experience. We are seeking candidates, interested in working in the addiction treatment field, to apply for our position for Recovery Specialist. The facility staff is a crucial part of...

  • Recovery Specialist

    4 weeks ago


    Columbia, United States APEX Recovery Rehab Full time

    APEX Recovery LLC, an innovative and integrative treatment center, has an exciting career opportunity for individuals with addiction treatment experience. We are seeking candidates, interested in working in the addiction treatment field, to apply for our position for Recovery Specialist. The facility staff is a crucial part of the program at APEX Recovery....


  • Columbia, United States NuVasive, Inc. Full time

    As a Revenue Cycle Specialist, you will play a pivotal role in the collections process by responding to inquiries from facilities and supporting the resolution of outstanding billings through strong customer service, documentation, and problem-solvin Specialist, Revenue, Cycle, Medical Billing, Customer Service, Manufacturing


  • Columbia, United States Prisma Health Full time

    Inspire health. Serve with compassion. Be the difference. Job Summary Under the direction of the department Manager, coordinates timely, comprehensive charge reconciliation for Perioperative Services. Performs internal charge audits and assists supervisor in overseeing the Chargemaster for assigned enterprise-wide departments. Coaches staff regarding...


  • Columbia, United States Grassroots Crisis Intervention Full time

    **Position Summary**: **Available schedule**: **CSC & Urgent Care (Dual): Monday - Friday; 4:00pm - 12:00am** - High School Diploma is required. Associates degree preferred. - _**Knowledge of the recovery process and the ability to facilitate recovery using established standardized mental health processes.**_ - _**At least 2 years in recovery from a...


  • Columbia, South Carolina, United States State of Maryland - MDH Local Health - Caroline County Full time

    Introduction\r GRADEASTD9\r LOCATION OF POSITIONMDH Caroline County Health Department\r18 Denton Plaza\rDenton, MD 21629\r Main Purpose of JobThis full-time contractual position will provide recovery support for clients, and general support for behavioral health management and staff. This position will be responsible for coordinating care and directing...


  • Columbia, United States Genesis Health Care, Inc. Full time

    **Title**: Reimbursement Specialist **Reports to**: Executive Financial Officer **Updated on**: 05/08/2024 **Status**: Non-Exempt **Approved by**: HR *** Primary responsibilities include ensuring all payments, adjustments and denials received from insurance companies are posted to patient accounts timely and accurately. Ensure rejections and denials...


  • Columbia, United States Nuvasive Full time

    Job Summary and Primary Responsibilities As a Revenue Cycle Specialist, you will play a pivotal role in the collections process by responding to inquiries from facilities and supporting the resolution of outstanding billings through strong customer service, documentation, and problem-solving skills. This is an excellent opportunity to build a robust career...


  • West Columbia, United States Lexington Medical Center Full time

    Managed Care & Payer Relations Full Time AM Shift 8 Consistently named best hospital, Lexington Medical Center dedicates itself to providing quality health services that meet the needs of its communities. Ranked #2 in the state and #1 in the Columbia metro area by U.S. News & World Report, Lexington Medical Center is the only hospital named one of the...


  • Columbia, United States Maxim Healthcare Services Full time

    The part-time Reimbursement Associate supports the revenue cycle by reviewing documentation submitted by the office to the Billing Team for accuracy, completeness, and to ensure that it meets all billing standards to be billed to the payer. The documents reviewed include but are not limited to: clinical notes, time tickets, time cards, purchase orders, and...

  • Peer Specialist

    2 weeks ago


    Columbia, Missouri, United States Compass Health Network Full time

    Due to critical service need of the communities we serve, we are offering a $1,000 sign-on bonus.* We are eager to continue to provide quality and compassionate care in our service areas and need you to make this happen The Peer Specialist will ignite the spark of hope that recovery is possible while promoting skills for coping with and managing symptoms...


  • Columbia, United States AbsoluteCARE Inc Full time

    Job Summary The Director of Finance and Patient Revenue oversees all financial aspects of AbsoluteCare's member billing process, with primary responsibility for payer contract relationships, negotiation, and performance adherence. This role also manages financial outcomes in partnerships with federally qualified health centers. The Director communicates...


  • Columbia, United States AbsoluteCARE Inc Full time

    Job Summary The Director of Finance and Patient Revenue oversees all financial aspects of AbsoluteCare's member billing process, with primary responsibility for payer contract relationships, negotiation, and performance adherence. This role also manages financial outcomes in partnerships with federally qualified health centers. The Director communicates...


  • Columbia, South Carolina, United States Department Of Veterans Affairs Full time

    SummaryThis position is eligible for the Education Debt Reduction Program (EDRP), a student loan payment reimbursement program. You must meet specific individual eligibility requirements in accordance with VHA policy and submit your EDRP application within four months of appointment. Approval, award amount (up to $200,000) and eligibility period (one to five...


  • Columbia, United States AbsoluteCARE Medical and Pharmacy Full time

    Job Description: Job Summary The Director of Finance and Patient Revenue oversees all financial aspects of AbsoluteCare's member billing process, with primary responsibility for payer contract relationships, negotiation, and performance adherence. This role also manages financial outcomes in partnerships with federally qualified health centers. The Director...


  • Columbia, South Carolina, United States Prisma Health Full time

    Inspire health. Serve with compassion. Be the difference.Job SummaryThe Customer Service Specialist works under the immediate supervision of supervisors/managers in Patient Financial Services (PFS) performing tasks of moderate to difficult complexity relating to both hospital and physician accounts. Customer Service Specialist handle a large volume of...


  • Columbia, United States Recovery Solutions Full time

    Compensation Range: $17 - $19 / hourYou Matter: Make a difference every day in the lives of the underserved Join a mission driven organization with a people first culture Excellent career growth opportunities Join us and find a career that supports: Caring for overlooked, underserved, and vulnerable patients Diversity, equity, inclusion, and belonging...


  • Columbia, United States APEX Recovery Rehab Full time

    Job DescriptionJob DescriptionApex Recovery is a co-occurring drug and alcohol treatment program founded in 2013. We are licensed by the Tennessee Department of Health Care Services and accredited by the Joint Commission. We are seeking a talented and experienced Psychiatrist to join our team at our new treatment facility located in Columbia, Tennessee. Our...


  • Columbia, United States Recovery Solutions Full time

    Compensation Range: $17 - $19 / hourYou Matter: Make a difference every day in the lives of the underserved Join a mission driven organization with a people first culture Excellent career growth opportunities Join us and find a career that supports: Caring for overlooked, underserved, and vulnerable patients Diversity, equity, inclusion, and belonging...


  • Columbia, United States Prisma Health Full time

    Inspire health. Serve with compassion. Be the difference. Job Summary To provide our patients a seamless entry in to the Prisma Health experience. The Referral Specialist interfaces with patients and physician office team members to accurately authorize various consultations, procedures and tests. The Referral Specialist utilizes each patient's preferred...