Senior Financial Analyst, Revenue Cycle Management
At Stony Brook Medicine, the Senior Financial Analyst, Revenue Cycle Management is responsible for the development, implementation, maintenance, review, and audit of the Hospital Charge Description Master to optimize revenue generation and maintain compliance with State, Federal, and third party payer regulations and requirements across the health system. This position provides charging advice, support, and education to Hospital departments, affiliates, and other stakeholders. Requires utilization of coding guidelines, billing and payment regulations, and third party contracts, as well as the Hospital inventory management system, electronic medical record, and departmental documentation programs. The CDM Analyst will continually interact with Hospital department staff to ensure that all chargeable procedures, treatments, supplies, and implants are appropriately charged. The Analyst will engage with service department staff and affiliates to develop and maintain audit programs which reconcile services performed to charges captured. In this role, the Analyst will work with Information Technology and service departments to develop testing and monitoring strategies to support the implementation of new charge capture systems and methodologies. Will utilize the hospital's charge master maintenance software (Craneware) to maintain the integrity of the charge master and ensure adherence to hospital policy with respect to pricing and materiality. It is expected the incumbent will be a CDM software (Craneware) super-user, assisting in system configuration and maintenance, acting to support service departments and interfacing with vendor technical support as needed. Qualified candidate will have the ability to perform retrospective and concurrent charge capture audits utilizing both software tools and/or E.M.R. and documentation review. May assist in the resolution of pre-billing charging issues and post-payment charge related denials.
Duties of a Senior Financial Analyst Revenue Cycle Management may include the following, but are not limited to:
- Provide charging advice, support, and education to Hospital departments, affiliates, and other stakeholders.
- Utilization of coding guidelines, billing and payment regulations, and third party contracts, as well as the Hospital inventory management system, electronic medical record, and departmental documentation programs.
- Continually interact with Hospital department staff to ensure that all chargeable procedures, treatments, supplies, and implants are appropriately charged.
- Engage with service department staff and affiliates to develop and maintain audit programs which reconcile services performed to charges captured.
- Work with Information Technology and service departments to develop testing and monitoring strategies to support the implementation of new charge capture systems and methodologies.
- Utilize the hospital's charge master maintenance software (Craneware) to maintain the integrity of the charge master and ensure adherence to hospital policy with respect to pricing and materiality.
- Perform retrospective and concurrent charge capture audits utilizing both software tools and/or E.M.R. and documentation review.
- May assist in the resolution of pre-billing charging issues and post-payment charge related denials.
- Assist in system configuration and maintenance.
- Act to support service departments and interfacing with vendor technical support as needed.
- May assist in the resolution of pre-billing charging issues and post-payment charge related denials.
- Other duties as assigned.
Qualifications
Required Qualifications:
- Bachelor of Science in Nursing, Accounting, Finance, Health Information Management, Health Administration, Computer Science, or related field or Associates Degree plus relevant professional certification, licensure, and experience.
- Minimum three plus years' experience in charge/reimbursement analysis, maintenance, audit, or review for a Hospital Finance or Revenue Cycle Department.
- Strong working knowledge of CPT, HCPCs, and ICD-10 coding principles.
- Proficient in MS Excel.
- Excellent written and verbal communication skills.
Preferred Qualifications:
- CCS, CCS-P, CPC, CCDS, RHIA, or RHIT certification.
- Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and New York Medicaid reimbursement methodologies.
- Knowledge of other governmental and third party payer reimbursement methodologies.
- Proficiency in the use of Craneware Active Charge Master Toolkit, Pharmacy Chargelink, Supplies Chargelink, and/or Bill Analyzer.
- Experience in Revenue Cycle Operational areas including: coding, revenue integrity, patient accounting, and/or reimbursement.
Special Notes:
Resume/CV should be included with the online application. This position will remain posted until filled or for a maximum of 90 days. An initial review of all applicants will occur two weeks from the posting date. Candidates are advised on the application that for full consideration, applications must be received before the initial review date (which is within two weeks of the posting date). If within the initial review no candidate was selected to fill the position posted, additional applications will be considered for the posted position; however, the posting will close once a finalist is identified, and at minimal, two weeks after the initial posting date. Please note, that if no candidate were identified and hired within 90 days from initial posting, the posting would close for review, and possibly reposted at a later date.
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 may be 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 may be 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.
Prior to start date, the selected candidate must meet the following requirements:
- 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 4 panel drug screen.
- Meet Regulatory Requirements for pre-employment screenings.
- Provide a copy of any required New York State license(s)/certificate(s).
Failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer. The hiring department will be responsible for any fee incurred for examination.
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. If you need a disability-related accommodation, please call the University Office of Equity and Access at (631)632-6280.