Campus Description: Stony Brook University Medical Center, Long Island’s only academic medical center, is about making a real difference in our patients’ lives. We do it by starting with the best ideas and hiring the best people to turn those ideas into the finest medical care on Long Island. We are the region's only tertiary care center and Level 1 Trauma Center. Stony Brook’s Cancer Center, Heart Center, and Women and Infants Center—all Centers of Excellence—are integral to our clinical strategic priorities that also include geriatrics, neurosciences, and trauma and emergency medicine. Our 591-bed Hospital has recently been modernized and expanded to accommodate leading-edge technology and enhance our delivery of patient and family centered care. Become a member of our team.

Descriptive Title: TH Senior Financial Analyst-Supervisor of Audits and Special ProjectsREF#: UH-S-5399-12-S
Budget Title: same as aboveState Professional Position
Department: Managed CareState Line#: 18744
Grade: SL-4Campus: Stony Brook-University Hospital
Salary: Commensurate with experience
THIS POSTING IS NOT CURRENT !!!
Required Qualifications: Bachelor's Degree and four years of relevant experience. Experience in working with Managed Care and RAC Denials. A proficiency in reviewing Managed Care Contracts.
Preferred Qualifications: Three to five years experience in Managed Care and RAC denials. An understanding of NYS Insurance Law, Medicare and Managed Care regulations. A track record in reducing denials. Prior experience in supervising staff. Proficiency in billing and appeal guidelines.

Brief Description of Duties:
  • Supervise Auditing Staff.
  • Help create and maintain calculation spreadsheets and tools for all contractual (and non-contractual) DRG rates based on thorough understanding of all managed care contracts and state and federal payment policies and methodologies.
  • Have a proficient understanding of billing/appeal guidelines.
  • Help maintain database used by a team of auditors to track, analyze, and respond to audits received from governmental agencies such as HMS, OMIG, etc.
  • Provide denial statistics and data to senior hospital management, hospital attorneys and other departments as needed.
  • Identify underpayments, and work with third party payers to ensure that the hospital was paid promptly and accurately.
  • Review denials of accounts to identify patterns of abuse and violations of law such as Public Health Law, NYS Insurance Law, and/or Medicare Managed Care Law.
  • Denial management, track all Managed Care, IPRO & RAC Medical necessity denials, DRG reassignments, and all Inpatient medical record requests from Managed Care Organizations, IPRO, and RAC using MS Access database.
  • Have a thorough understanding of Insurer contracts and payment methodologies.

Special Notes: All Hospital positions are subject to changes in pass days and shifts as necessary. This position may require the wearing of respiratory protection which may prohibit the wearing of facial hair. Please note Stony Brook University Medical Center is a smoke free environment.

Full-time day position 830am-5pm.

Please note: Prior to start date, the selected candidate must meet the following requirements: Successfully complete pre-employment physical examination and obtain medical clearance from Stony Brook University's Employee Health Services, clear a background investigation; submit (3) written references, and provide a copy of the required license(s)/certificate(s). Please be advised that failure to comply with any of the above requirements could result in a delayed start date and/or revocation of the employment offer.

The selected candidate must successfully clear a background investigation.

Application Procedure: Those interested in applying for the above position should submit a State Application, resume and cover letter reflecting UH# to:
Stony Brook University Medical Center
Human Resources Department
Professional Employment
3 Technology Drive, Suite 100
East Setauket , NY 11733-4073


Applications for this position must be received, as specified in the Application Procedure Section, no later than 5:00 PM Eastern Time on 02/28/2012, unless specifically noted otherwise in the Special Notes Section.

STONY BROOK UNIVERSITY IS AN AFFIRMATIVE ACTION/EQUAL OPPORTUNITY EMPLOYER. WE ENCOURAGE PROTECTED VETERANS, INDIVIDUALS WITH DISABILITIES, WOMEN AND MINORITIES TO APPLY.
IF YOU NEED A DISABILITY-RELATED ACCOMMODATION, PLEASE CALL THE UNIVERSITY HUMAN RESOURCE SERVICES DEPARTMENT AT (631) 632-6161 OR THE UNIVERSITY HOSPITAL HUMAN RESOURCES DEPARTMENT AT (631) 444-4700.
IN ACCORDANCE WITH THE TITLE II CRIME AWARENESS AND SECURITY ACT, A COPY OF OUR CRIME STATISTICS IS AVAILABLE UPON REQUEST BY CALLING (631) 632-6350. IT CAN ALSO BE VIEWED ON-LINE AT THE UNIVERSITY POLICE WEBSITE AT http://www.stonybrook.edu/police

Job Category: B) Administrative and Professional Positions (excluding teaching and patient/clinical care).
Posting Date: 02/14/2012
Additional Categories: