Reports to the hospital Chief Financial Officer and directs the revenue analysis function for the assigned hospital and ambulatory sites. Responsible for preparation and completion of eReserve. Responsible for the analysis of eReserve and items/trends that significantly impact net revenue. Responsible for the review and approval of manual adjustments and refunds. Monitors/analyzes AR/Disputes and assists with Bad Debt Initiatives. Monitors and communicates non-reimbursable charges (e.g., ABN not signed, denials, disputes, bad debt). Reviews proposed managed care contracts and identify any issues or concerns with implementation of the terms prior to the contract being finalized. Assists in analyzing data to verify contract terms have been loaded correctly into IMaCs and claims properly adjudicated during and after managed care negotiations. Monitors/reviews billing, A/R and reconciliation for hospital specific contracts (e.g., non-IMaCs, local employer). Works with hospital departments to resolve revenue cycle issues (e.g., orders, charging, Patient Access, DNFB, DNSP, QS, disputes). Works with hospital leadership on revenue cycle issues. Works with hospital related entities (e.g., clinics, universities), if applicable. Facilitates revenue cycle meetings (preparation, facilitation and follow-up). Supports/directs/monitors the following: department head meetings, chart audit meetings, compliance committees, charge master review/updates, pass through invoice retrieval, complex (e.g., 'High $" or "At-Risk") in-house patient meetings, hospital revenue cycle implementation initiatives, internal/external Audit Assistance, engaging legal for collection Issues.
1. Bachelor's degree in Business, Health Administration or related area, or the equivalent combination of education and/or experience.
2. Eight years of experience in A/R management and/or Managed Care contracting and analysis, including experience directing a multi-facility business office.
1. High level of analytical ability required to compile data in the revenue cycle; review, interpret and analyze complex financial reports and activities and present findings. Ability to understand relationships within the revenue cycle process, identify potential discrepancies and resolve complex business operational issues. Ability to evaluate processes and conduct cost and pricing studies. Analytical ability to evaluate processes and conduct cost pricing studies.
2. Communication and/or interpersonal skills for contact with internal and external customers/stakeholders to obtain and interpret a variety of information based on knowledge of departmental practices, DMC policies and programs and specific technical and regulatory knowledge. Discretion must be exercised in deciding what and how to communicate. Conflict resolution skills must be exercised where policy issues are concerned both within the functional area and interdepartmentally. Diplomacy, tact and listening skills are required. Ability to read, interpret and write technical materials.
3. Project management skills including the ability to define program, project, or process objectives, identify stakeholders and their interests, plan steps, coordinate and allocate human, technological and fiscal resources to accomplish goals and objectives in a resourceful yet timely manner.
4. Thorough understanding of mathematical logic to compute figures related to complex financial studies, to see relationships between data and to draw valid conclusions.
5. Strong technical knowledge of financial analysis billing and reimbursement experience.
6. Thorough understanding of financial services computer systems, accounts receivable and collection report format, policies, and procedures.
7. Proficient in the use of a personal computer and spreadsheet software.
Job: Finance and Accounting
Primary Location: Detroit, Michigan
Facility: DMC Receiving Hospital
Job Type: Full-time
Shift Type: Days
If Other Shift, Specify: RECRUITER NOTE: Grade of position is 268, fix on backend
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905036073
About DMC Receiving Hospital
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.