Job Information
Stony Brook Medicine (Stony Brook University Hospital) Revenue Cycle Manager in Stony Brook, New York
Position Summary
At Stony Brook Medicine, our Revenue Cycle Manager for the Radiation Oncology department is a valuable member of our team, who oversees the processes to provide efficient billing and revenue management for the department. The Revenue Cycle Manager will report to the Administrative Director and assist with various financial projects within the department.
Duties of a Revenue Cycle Manager for Radiation Oncology may include the following but are not limited to:
- Responsible for revenue collection activities.
- Ensure that all patients receiving hospital services are pre-certified to receive these services and/or a referral is obtained.
- Utilizing ICD-10 CM and CPT coding guidelines; review diagnoses and procedures codes ensuring correct charges are sent to hospital and practice billing systems.
- Familiarity with the NCCI Policy Manual and CCI edit bundling rules.
- Ability to research and understand Medicare LCD/NCD's and commercial payer coverage policies ensuring Medical Necessity for Medicare Patients.
- Develop a system to resolve denials for services with the Patient Accounts staff.
- Develop method to track denials and resolve systemic problems.
- Responsible for improved medical record documentation through the Service Lines.
- Facilitate communication between administration, billing staff, clinicians, and financial staff to enhance billing and collection and to ensure proper coding for billing purposes.
- Ensure correct coding and documentation on all procedures related to Radiation Oncology E&M and procedures.
- Performs analysis of charge edits and charge reconciliation. Responsible for both hospital and physician charge capture.
- Responsible for supervising and training/education in coding and billing for the insurance authorization staff.
- Must keep current with CMS and other third party carriers referring to Radiation Oncology.
- Review contracts with the manage care departments for hospital and physician charges.
- Assist Administrative Director in revenue tracking for Radiation Oncology.
- Provide statistical reporting on all financial aspects of Radiation Oncology (assist in preparing financial reports, projections, and financial analysis)
- Assist the clinical trial office with planning, billing and other aspects related to Rad Onc clinical trials.
- Other miscellaneous financial responsibilities as required by the Department Administrator for Radiation Oncology.
Qualifications
Required:
- Bachelors degree and a minimum of three years of financial experience in either a hospital or practice setting.
- Successful completion of a coding program with one of the following coding credential: CCS-P AHIMA or CPC AAPC
- Three or more years' experience in outpatient hospital coding or auditing.
- Strong knowledge of ICD-10-CM, HCPCS/CPT 4 coding and use of modifiers.
- Familiarity with the NCCI Policy Manual and CCI edits.
- Ability to research and understand Medicare LCD's and commercial payer coverage policies.
- Masters degree in healthcare or related field.
- Experience in Radiation Oncology billing and coding.
- Advanced proficiency with MS Office Applications including Excel.
- Stony Brook Medicine is a smoke free environment. Smoking is strictly prohibited anywhere on campus, including parking lots and outdoor areas on the premises.
- All Hospital positions maybe subject to changes in pass days and shifts as necessary.
- This position may require the wearing of respiratory protection, which may prohibit the wearing of facial hair.
- This function/position maybe designated as "essential." This means that when the Hospital is faced with an institutional emergency, employees in such positions may be required to remain at their work location or to report to work to protect, recover, and continue operations at Stony Brook Medicine, Stony Brook University Hospital and related facilities.
- Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook Medicine's Employee Health Services*
- Complete electronic reference check with a minimum of three (3) professional references.
- Successfully complete a 5 panel drug screen*
- Successfully complete a Background Check investigation.
- Provide a copy of any required New York State license(s)/certificate(s).
Stony Brook University is committed to excellence in diversity and the creation of an inclusive learning, and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status and all other protected classes under federal or state laws.
Minimum Salary: 31200.00 Maximum Salary: 31200.00 Salary Unit: Yearly