ASSOCIATE DIRECTOR (OBH) - PAYOR RELATIONS and PHYSICIAN SUPPORT
Job description
- Establish strong relationships with key payors in our market and counterparts in the Managed Care division of the OBH Finance Department.
- Optimize tools such as Cactus/Symplr and Athenahealth to produce pristine provider data for payor enrollment and physician directories.
- Manage and motivate staff to perform at the top of their titles.
- Lead payor delegation audits and work closely with the OBH Medical Staff Office to ensure compliance.
- Manage the enrollment and eligibility denial workqueue and the claim edits related to payor enrollment.
- Work closely with the Director of Revenue Cycle services to identify opportunities for improved revenue capture and/or optimized Part B revenue.
- Work closely with ambulatory care leadership and finance to improve value-based revenue capture.
- Willingness to perform outreach to other community providers and assist with payor related issues.
- All other duties as requested.
Education:
- Bachelor's Degree required, in Health Care or Finance preferred.
- Extraordinary experience may be considered in lieu of the education requirement.
Experience:
- Minimum five (5) years prior work experience developing and managing protocols for payor enrollment
- Experience building a complex database is ideal, especially in a multi-site physician group setting.
Knowledge and Skills:
- Excellent interpersonal skills including ability to communicate clearly with people over the phone, in person, and in writing.
- EPIC and/or Athena environment experience is a plus.
Excellent communication, negotiating and problem solving skills.
Must possess strong organizational and analytical skills. Tact, credibility and excellent judgment essential.
Working knowledge of Excel, Word and Internet access.
Knowledgeable in physician billing, reimbursement, billing/scheduling software and physician electronic health records.
Understanding of HIPAA regulations.
- Membership in HFMA, ACHE or MGMA is a plus
- Position requires prolonged periods of sitting and use of a computer and screen viewing throughout the working day.
- Position requires prolonged periods of standing, reaching, walking throughout the working day.
- Position will be required to stoop, bend, lift, and carry items weighing up to 25 pounds.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The statements herein are intended to describe the general nature and level of work being performed by employees, and are not to be construed as an exhaustive list of responsibilities, duties, and skills required of personnel so classified. Furthermore, they do not establish a contract for employment and are subject to change at the discretion of the One Brooklyn Health System.
OBHS is an equal opportunity employer, it is our policy to provide equal opportunity to all employees and applicants for employment without regard to race, color, religion, national origin, marital status, military status, age, gender, sexual orientation, disability or handicap or other characteristics protected by applicable federal, state, or local laws.
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