Current Employees:

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Primary Location

Rapid City, SD USA

Department

CS Managed Care

Scheduled Weekly Hours

0

Starting Pay Rate Range

$26.14 - $32.67

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

Provides analytical and technical support to the Revenue Cycle team in the planning, implementation, coordination and ongoing system maintenance of the denial, underpayment and contract modeling system, currently Payment Integrity Compass (PIC).
Maximizes the Health System's revenue recovery efforts through effective coordination of the usage of Payment Integrity Compass by various Revenue Cycle staff.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions

*Flexible scheduling

Job Description

Essential Functions:

• Thoroughly understands the wide variety of reimbursement methodologies used through the Healthcare receivables industry.
• Functions as a super user for implementation and maintenance of computerized denial, underpayment contact modeling system.
• Responsibilities include verification and accuracy of data, compiling data and ability to translate information into multiple formats (Excel, Access, PowerPoint and white paper format).
• Provides monthly reporting that assists in identifying root causes of denials, underpayments, payer response and resolution to existing and prospective AR. •Responsible for coordinating work efforts needed to identify trends in underpayments, denials, revenue opportunities and revenue leakage.
• Works closely with each department responsible for root causes to trend issues and provides feedback that will result in reduced preventable denials and underpayments. Works collaboratively with respective departments to evaluate trends and be part of the team that works towards resolution.
• Works in collaboration with Managed Care Manager to obtain current Payer fee schedules and ensure accurate and timely loading, auditing, and validating of contract information.
• Creates and reviews operational reports for identification of improvement opportunities and makes recommendations to re-engineer processes.
• Participates in Managed Care, Value Based Incentive Program Committee meetings and provides reports and analytics for presentations as needed.
• All other duties as assigned.

Additional Requirements

Preferred:
Experience - 1+ years of Hospital Experience; 3+ years of Revenue Cycle Experience
Education - Bachelors degree in Healthcare Administration or Related Field

Physical Requirements:
Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Revenue Cycle

Job Family

Patient Financial Services

Shift

Requires the ability to work assigned schedules and hours as determined by the department

Employee Type

PRN

15 Corporate Services Division

Make a difference.  Every day.

Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.