Supervisor-Revenue Recovery

Now hiring a Supervisor-Revenue Recovery!

Presbyterian Healthcare is seeking a Supervisor-Revenue Recovery to responsible for the day to day supervision of the Revenue Recovery Team, overseeing both Hospital and Professional Billing, to ensure that all functions related to the Revenue Recovery Team are performed within established quality and quantity standards. Assists manager with the initiation, monitoring and reconciliation of all activity specific to a submitted variance recovery. Requires extensive knowledge of contractual agreements, contract interpretation, reimbursement methodologies and system configuration. Will assist with the contract load within Epic and validation process working in conjunction with Network Contracting and the IT group.

How you belong matters here.

We value our employees' differences and find strength in the diversity of our team and community.

At Presbyterian, it's not just what we do that matters. It's how we do it - and it starts with our incredible team. From Information Technology to Food Services and beyond, our non-clinical employees make a meaningful impact on the healthcare provided to our patients and members.

Why Join Us

Full Time - Exempt: Yes
• Job is based Rev Hugh Cooper Admin Center
• Work hours: Days
• Benefits: We offer a wide range of benefits including medical, wellness program, vision, dental, paid time off, retirement and more for FT employees.

Prefer Qualifications:

• Two years experience in healthcare billing and/or collections roles required.

• One to two years of college level courses OR three years of healthcare business office experience in lieu of college level courses.
• Two years experience in healthcare billing and/or collections roles required.
• Must have extensive knowledge of reimbursement methodologies i.e. DRG, OPPS, APC, fee schedule.
• Must be familiar with medical terminology, ICD-10, CPT, HCPCS and revenue coding required.
• Must be familiar with CMS 1500 and UB-04 claim forms, 837 electronic claims processing, and 835 electronic remittance processing.
• Must demonstrate strong analytical skills, strong interpersonal skills, and the ability to interface with various departments both within the revenue cycle as well as externally.
  
  

• Supervises the day to day work of the Revenue Recovery Team to ensure that all accounts are processed in accordance with established contracts and payment rates. Monitors system generated reports, quality audits and work queues, recommends new methods and processes, and coordinates resources to improve collection efficiency and effectiveness.
• Initiates, monitors and reconciles all activities specific to a submitted variance recovery and payer intervention.
• Ensures that all processes are documented, in accordance with PHS standards, to facilitate regulatory compliance and successful outcomes to internal/external review and audits.
• Identifies and resolves complex issues related to payment variances. Ensures internal and external issues that affect both PB and HB are properly addressed with all affected parties, as well as facilitating resolution with payers.
• Assist with the contract loads and validation process working in conjunction with Network Contracting and IT.
  
  

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.