Feb 08, 2019
supporting the technical operations of the Managed
Care Administration team and EPIC Tapestry application by
monitoring, analyzing, and recommending improvements. The _team_ works on complex projects and problems that require in-depth
evaluation, understanding of the business processes and innovative solutions. This
position will include monitoring, basic analysis, and distribution of incoming
requests, and periodic auditing of completed projects and contract builds
(including annual internal process audits). In addition, this position will
include analysis of patient benefit activity and various assignments that do not
conflict with the audit responsibility. This
individual will develop strong working relationships with Client Services,
Patient Services, Business Services, and IS technical teams.
review and communication with Patient Services and Health plans (primarily
around Encounter data, Patient Co-pays, and covered services).
+ Bachelor'sDegree or equivalent education and experience
+ 4+ years at Sutter Physician Services orother healthcare facility in a business office setting required.
+ Basic understanding of medical terminology(CPT, HCPCS, Diag codes, Rev Codes, etc).
+ Prior audit experiencepreferred (contract review and/or process-related auditing).
+ Knowledge of Epic Softwarepreferred.
+ Knowledge of HealthcareVendor contracts preferred.
+ Knowledge of insurance datarequired to accurately and efficiently review claim activity (primarilyManaged Care).
+ Demonstrated ability tosuccessfully manage multiple projects with varying priorities andaudiences.
+ Demonstratedability in analyzing patient account problems to formulate logical andobjective conclusions or recommendations for solutions.
**Organization:** Sutter Physician Services
**Employee Status:** Regular
**Employee Referral Bonus:** No
**Position Status:** Non-Exempt
**Job Shift:** Day
**Shift Hours:** 8 Hour Shift
**Days of the Week Scheduled:** Monday-Friday
**Weekend Requirements:** None
**Schedule:** Full Time
**Hrs Per 2wk Pay Period:** 80
All qualified applicants will receive consideration for employment without regard to race, color, creed, religion, marital status, sexual orientation, registered domestic partner status, sex, gender, gender identity or expression, ancestry, national origin (including possession of a driver's license issued to individuals who did not present proof of authorized presence in the U.S.), age, medical condition, physical or mental disability, military or protected veteran status, political affiliation, pregnancy or perceived pregnancy, childbirth, breastfeeding or related medical condition, genetic information or any other characteristic made unlawful by local, state, or federal law, ordinance or regulation. External hires must pass a background check/drug screening. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state, and local laws, including but not limited to the San Francisco Fair Chance Ordinance.