Contract Compliance Spec - PFS NW Business Support - Miamisburg - FT/Days
- Miamisburg, OH
- Permanent
- Full-time
- Serving the residents of Warren, Butler, and Southern Montgomery counties for over 40 years.
- Kettering Health Miamisburg, formerly Sycamore Medical Center, is a full-service hospital located minutes west of the Dayton Mall on Miamisburg-Centerville Road off I-75 in Miamisburg, Ohio.
- The cornerstone services for KH Miamisburg have been Bariatric surgeries and Orthopedic care.
- Expanded services include emergency care, sleep center, mammography, breast MRI, cardiac catheterization lab, wound center and DEXA scanning.
- 142 bed facility
- Awarded with 100 Top Hospital by IBM Watson Health for the 10th time in 2019.
- In 2020, KH Miamisburg received an “A” from the Leapfrog Group, a national patient safety watchdog, ranking among the safest hospitals in the United States.
- Accredited by the American College of Emergency Physicians as a Level 3 Geriatric Emergency Department.
- KH Miamisburg received several awards from Healthgrades:
- Outstanding Patient Experience Award (2017-2019)
- America’s 100 Best Hospitals for Prostate Surgery Award (2020)
- Joint Replacement Excellence Award (2020)
- Responsible for monitoring payment from Managed Care third party payers for compliance against contract terms.
- Following up and working collaboratively with payers to ensure correct payment is received.
- Responsible for monitoring expected reimbursement software and its results to assure the information is useful, accurate and appropriately applied.
- Acting as a liaison between the Network PFS and other departments and the Payer to understand, address and bring resolution to issues.
- Reports to the Manager of Contract Compliance.
- Min 5 years Hospital Billing and followup required
- Prior Physician Billing and follow up experience preferred
- High School graduate or its equivalent
- Knowledge of Hospital Patient Accounting functions required.
- Five plus year’s experience working with Managed Care contract terms preferred.
- Professional communication skills both written and verbal required.