Allegheny Health Network
Job Description :
Responsible for ensuring that the health system maintains financial health through timely, accurate and efficient hospital claim billing and follow-up to ensure payment for all (governmental or non-governmental) payers.
- Ensures timely and accurate claim submission of all AHN governmental or non-governmental hospital claims. (20%)
- Designs, implements, and maintains workflow to ensure timely follow-up of all governmental and/or nongovernmental accounts. (20%)
- Works in collaboration with the Director of Hospital Managed Care Contract Compliance to identify and provide payer behavioral trending data. (20%)
- Identifies and mitigates issues that may result in delay of claim submission or payment for all nongovernmental payers contracted with AHN. (20%)
- Maintains a working knowledge of large payers’ contractual billing timely filing and other terms that may impact reimbursement and maintains compliance. (10%)
- Prepares, monitors, and maintains an annual expense budget. (10%)
- Degree in Finance, health related field, or BSN, or equivalent relevant industry experience of >15 years
- 5 years hospital revenue cycle management experience with managed care receivables
- 5 years of leadership experience
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.
Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities, and prohibit discrimination against all individuals based on their race, color, religion, sex, national origin, sexual orientation/gender identity or any other category protected by applicable federal, state or local law. Highmark Health and its affiliates take affirmative action to employ and advance in employment individuals without regard to race, color, religion, sex, national origin, sexual orientation/gender identity, protected veteran status or disability.
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