Healthcare Revenue Management Professional

6 days ago

Buffalo, New York, United States Seneca Holdings LLC Full time
About the Role

We are seeking a highly skilled Revenue Cycle Specialist to join our team at Seneca Holdings LLC. As a key member of our organization, you will play a critical role in supporting the Defense Health Agency (DHA) in developing and implementing a Revenue Integrity program and operations.

Key Responsibilities
  • Revenue Cycle Expertise: Provide extensive Subject Matter Expert (SME) knowledge in MHS GENESIS Revenue Cycle, including all Charge Services, to support the DHA-project.
  • Business Process Optimization: Support the system's ability to provide integrated solutions and services to optimize business workflows and control costs to collect across acute, ambulatory, specialty, and inpatient venues.
  • Assessment and Roadmap Development: Conduct an assessment of the current state and provide a foundation for developing a roadmap and plan for the development of the RI functionality in DHA.
  • Charge Analysis and Reconciliation: Analyze and reconcile suspended charges and Discharged Not Final Billed (DNFB) based on the analysis, use a sprint framework to identify and prioritize proposed projects and reduce the backlog.
  • Revenue Cycle Program Development: Support a roadmap to pilot and then roll out a scalable enterprise Revenue Cycle program.
  • Decision-Support Tools: Help design and implement a portfolio of Revenue Cycle decision-support tools focused on the most important Key Performance Indicators for fiscal health.
  • Business Process Re-Engineering: Support and leverage business process re-engineering efforts to achieve standardization within all Revenue Cycle areas.
  • Revenue Cycle Management: Apply principles and practices in Revenue Cycle management, such as charge capture, coding, billing, reimbursement, denial management, and compliance.
  • Training and Support: Provide training support/collaboration on end-user training materials and workflow collateral.
Requirements
  • Education: Requires a Bachelor's degree in a clinical or healthcare-related field. An Associate degree combined with an additional five (5) years of Revenue Cycle experience may be substituted for the Bachelor's degree.
  • Clearance: Can achieve a Favorable Suitability Adjudication, based on a T1 background investigation.
  • Citizenship: Due to the nature of the government contract requirements and/or clearance requirements, US citizenship is required.
  • Revenue Cycle Knowledge: Substantial knowledge and a working understanding of Revenue Cycle concepts, business processes, and/or operations within the healthcare industry.
  • Analytical and Communication Skills: Ability to analyze and interpret complex data, processes, and reports related to revenue cycle and integrity and identify and resolve related issues and problems.
  • Collaboration and Communication: Ability to collaborate and communicate effectively with team members, clients, business partners, and other various stakeholders involved in revenue cycle.
  • Microsoft Office 365: Microsoft Office 365 proficiency (Excel, Word, PowerPoint).
  • Excellent Communication Skills: Excellent oral, written, and interpersonal skills.
Desired Qualifications
  • Favorable Suitability Adjudication: Must have a Favorable Suitability Adjudication, based on a current T1 background investigation.
  • DHA Issued Common Access Card: Possess a DHA issued Common Access Card.
  • Military Health System Experience: Substantial experience within the Military Health System (MHS) environment and requisite knowledge of revenue cycle operations.
  • Software Applications and Tools: Ability to use various software applications and tools to perform Revenue Cycle functions, such as Electronic Health Record systems (Oracle/Cerner Patient Accounting Module (CPAM)), billing/claim solutions/systems (Electronic Claims Clearinghouse (SSI), 3M 360 Encompass Institutional & Professional Coding, Claim Scrubber Edits (Alpha ii), Dentrix Billing, Patient Statements/Letters (RevSpring)), and data analytics tools/repositories (Excel, Power BI, SAS, Tableau, HealtheAnalytics).
  • MHS Billing and Coding Policies: Knowledge of MHS billing and coding policies and regulations.
  • Oracle/Cerner EHR Experience: Experience with the Oracle/Cerner Electronic Health Record (EHR) (MHS GENESIS), Patient Accounting Module (CPAM) and reports: HealtheAnalytics, Discern Reporting Portal, and Lights On Network, ideally in the MHS environment.
  • MHS GENESIS Roles: Experience in the following MHS GENESIS roles: CPA: Accounting/Biller/Poster, CPA: Management, CS: Charge Analyst Local, and Scheduling Basic.
About Seneca Holdings LLC

Seneca Holdings LLC is committed to building an inclusive work environment that encourages, supports, and celebrates the diversity of our employees. We recognize that an inclusive corporate culture improves how we support our customers and also improves the collective impact we can make in our communities.

Equal Opportunity Statement: Seneca Holdings provides equal employment opportunities to all employees and applicants without regard to race, color, religion, sex/gender, sexual orientation, national origin, age, disability, marital status, genetic information and/or predisposing genetic characteristics, victim of domestic violence status, veteran status, or other protected class status. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leave of absence, compensation and training. The Company also prohibits retaliation against any employee who exercises his or her rights under applicable anti-discrimination laws. Notwithstanding the foregoing, the Company does give hiring preference to Seneca or Native individuals. Veterans with expertise in these areas are highly encouraged to apply.

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