Revenue Specialist

3 weeks ago


SetauketEast Setauket, New York, United States Stony Brook Medicine Full time
Job Summary

Stony Brook Medicine is seeking a highly skilled Revenue Specialist to join our team. The successful candidate will provide operational support within the hospital's Patient Accounting Department, ensuring the efficient processing of hospital claims and the resolution of any issues that may arise.

Key Responsibilities
  • Prepare and submit hospital claims in a timely and accurate manner
  • Review and investigate denied claims to identify the root cause of the issue
  • Follow up on rejected or denied claims to ensure that they are resolved in a timely manner
  • Process appeals and liaise with third-party billing and collection agencies as needed
  • Identify and address any issues or patterns with claims/insurance companies to increase revenue and prevent unnecessary denials
Requirements
  • Bachelor's degree in Accounting, Business, Health Information Management, or a related field
  • Minimum of 6 months of business experience, preferably in a healthcare setting
  • Excellent written and oral communication skills
  • Proficiency with Microsoft Office
Preferred Qualifications
  • Experience with Inpatient and Outpatient billing requirements (UB-04/837i) and/or CMS Medicare and New York Medicaid reimbursement methodologies
  • Knowledge of third-party payer reimbursement and managed care contracts
  • Experience investigating, reviewing, and following up on rejected/denied inpatient and outpatient hospital claims
  • Knowledge of CPT, HCPCs, and ICD-10 coding principles
What We Offer

Stony Brook Medicine offers a competitive salary and benefits package, as well as opportunities for professional growth and development. If you are a motivated and detail-oriented individual with a passion for healthcare, we encourage you to apply for this exciting opportunity.



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