This description is a summary of our understanding of the job description. Click on 'Apply' button to find out more.

Role Description

Drives the end-to-end identification, analysis, and resolution of payment discrepancies to maximize revenue integrity and ensure total contract compliance.

• Executes deep-dive root cause analyses on coding errors and payer adjudication trends to significantly improve accounts receivable net down accuracy.
• Leads high-level negotiations and dispute resolution with payers to recover underpayments and enforce adherence to CPT, ICD-10, and HCPCS fee schedules.
• Collaborates cross-functionally with coding and billing teams to implement front-end process improvements and provide strategic data for future contract negotiations.
• Utilizes RCM software to monitor and report on critical KPIs, including underpayment recovery rates, aging, and overall payer performance trends.

Qualifications

• High School diploma equivalency with 5 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management OR Associate's degree/Bachelor's degree with 3 years of applicable cumulative job specific experience required, with 2 of those years being in leadership/management.
• Preferred Credential(s): Accountant. Licensure required relevant to state in which work is performed.

Requirements

• Demonstrate 8–10 years of progressive healthcare revenue cycle leadership experience with a specific focus on contractual underpayment recovery and payer compliance.
• Showcase a proven track record of implementing automation and technology solutions to streamline the recognition and resolution of payment variances.
• Possess a high degree of executive presence with the ability to influence stakeholders and communicate financial risks at the C-suite level.

Benefits

• Comprehensive health coverage: medical, dental, vision, prescription coverage and HSA/FSA options.
• Financial security & retirement: employer-matched 403(b), planning and hardship resources, disability and life insurance.
• Time to recharge: pro-rated paid time off (PTO) and holidays.
• Career growth: Ascension-paid tuition (Vocare), reimbursement, ongoing professional development and online learning.
• Emotional well-being: Employee Assistance Program, counseling and peer support, spiritual care and stress management resources.
• Family support: parental leave, adoption assistance and family benefits.
• Other benefits: optional legal and pet insurance, transportation savings and more.