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Director of Accreditation and Visiting Professor in Education

Revint Solutions

Director of Accreditation and Visiting Professor in Education

Chadds Ford, PA
Paid
  • Responsibilities

    COMPANY OVERVIEW

    For more than 20 years, Revint Solutions has been helping healthcare providers recover revenue and bolster their bottom lines.  Revint Solutions’ recovery methodology and technology platforms work to optimize the revenue cycle.  With the use of intelligent proprietary analytics, our recovery teams are truly the best and most experienced at finding and recovering lost or unidentified revenue.  We take a holistic approach to revenue recovery and look at not only contract compliance, but charge and revenue integrity, as well as regulatory compliance such as Transfer DRG and DRG validation.  Today, we serve over 1,600 hospitals and health systems nationwide and are proud of numerous awards and recognitions, including being consistently named one of the Best Places to Work both locally and nationally.

     

    DESCRIPTION

    The Underpayment Recovery service line independently calculates the reimbursement amount for a set span of hospital data and compares it to the amounts the hospital already received.  When discrepancies are identified, the claims are researched in the client’s patient accounting system, medical records and UB04 detail.  If the underpayment or denial is validated, we appeal to the payer for additional reimbursement.

    In addition, we provide our clients with claims’ data showing payer performance and root-cause analysis of underpayment issues, which can be leveraged when negotiating with payers and assessing the overall business performance. We also provide our clients with insight into the underpayment issues we identify.  In doing so, we help our clients to improve their own processes and minimize revenue leakage.  

    As the Senior Consultant in our Underpayment Recovery practice, you will conduct analysis, trending and data mining on large data sets, in addition to working with Provider Representative from insurance companies and writing and editing appeal letters.  You will also be asked to conduct research and produce summaries of your findings for client management and other team members. Senior Consultants will mentor and train junior level staff in the service line in addition to helping manage the overall project. You will also be directly responsible for the creation of monthly client invoices, monthly Executive Summaries and client meeting communication.  This position requires good time management and the ability to be flexible to various scenarios.  Additionally, Senior Consultants should bring a creative and insightful point of view.

     

    RESPONSIBILITIES

    • Analysis of hospital contracts to identify potential underpayment opportunities
    • Translation of contract terms into mathematical formulas to identify underpaid claims
    • Identify opportunities for process improvements for both client and internal processes
    • Manage day-to-day work for the project team
    • Train staff in the areas of underpayment identification, healthcare industry processes and standards, communicating and negotiating with insurance companies
    • Escalate and resolve payment disputes with payers by serving as a liaison between client and payer
    • Generate long-range engagement projections including identifications, revenue and staffing needs
    • Establish metrics to monitor staff performance
    • Prepare and deliver performance evaluations for staff and resolve any staff related issues
    • Creation of monthly client reports
    • Participate in client meetings
    • Provide support with marketing proposals
    • Delegation/assignments of tasks to junior staff
    • Participation in one (or more) administrative areas (ie., Culture Crew, Tech Team, ……)

     

    REQUIRED QUALIFICATIONS

    • Bachelor’s degree in Health Care Management, Business, Finance or Accounting or related discipline
    • 3-5 years of healthcare experience; patient account services, admissions, registration, billing or payer contracting
    • Thorough understanding of reimbursement methodologies (Managed Care contracts, Medicare and Medicaid); experience may include negotiating, auditing or modeling for contract negotiation purposes

     

    DESIRED QUALIFICATIONS

    • Ability to develop logic to price claims under various reimbursement methodologies including coordination of benefits, third party liability, Diagnosis Related Groups (DRGs), Case Rates, Ambulatory Payment Classification (APC), Outpatient Fee Schedules, Division of Financial Responsibility (DoFR) and Capitation
    • Excellent written and verbal communication skills
    • Extensive knowledge of government compliance rules and issues as it pertains to health care billing, collection and reimbursement
    • Knowledge of the charge capture processes; prior experience conducting charge capture audits is a plus
    • Must be comfortable with large datasets; experience with MS Access or comparable database platforms
    • Proven leader, experience managing teams, effective time management and the ability to motivate and coach junior staff
    • Self-directed and organized with superior analytical and problem-solving skills
    • Ability to set long and short-term goals as well as maintain the necessary pace to reach them
    • Comfortable presenting to both internal and external stakeholders (C-suite)

     

    CULTURE FIT

    The culture at Revint Solutions embraces those that demonstrate a deep passion for solving the problems of healthcare with enthusiasm for building positive working relationships and winning as a team.  Take the work seriously, but don’t take yourself too seriously.  Creating a strong workplace culture has been one of our staples, which we believe encourages and inspires employees to do their best.  Join a fulfilling team of like-minded individuals who can get their work done, but still have fun!

     

    BENEFITS

    Revint Solutions provides an extremely competitive benefit package that includes a 401(k) match, medical/dental/vision insurance and more.

     

     

    Revint Solutions is an Equal Opportunity Employer

    Required Skills Required Experience

  • Qualifications

     The following credentials are required:

    • Masters Degree in Biological Sciences or related field with at least 18 credits in the discipline

    PLEASE NOTE: A complete application should include a cover letter; teaching philosophy statement, (if applying for a position in instruction); and an unofficial copy of your transcripts/licenses/or additional certifications.  You may upload these documents in STEP 5 of the application process. For all academic / instruction positions at Kishwaukee College, it is required that successful candidates provide OFFICIAL TRANSCRIPTS to the College.  In an effort to expedite the hiring process, we encourage candidates to supply copies of their transcripts in their application.  Should you be called for an interview, we strongly recommend that you bring your official transcripts in a sealed envelope. 

  • Industry
    Human Resources