Allegheny Health Network Careers

Date Posted: 6/1/16

Position Number: 51427

Location: North Shore

Allegheny Health Network is an integrated delivery network focused on preserving health care choice and providing affordable, high-quality care to the people in our communities.  With more than 14,000 employees including 7,400 health care professionals, nearly 200 primary care and specialty care practices, Allegheny Health Network includes seven hospitals in Pennsylvania with nearly 2,400 licensed beds.

Allegheny Health Network’s clinical expertise ranges from primary care to the most complex surgical procedures.  Services include cancer diagnosis and treatment, cardiovascular care, neurological and neurosurgical services, organ transplantation, orthopedic and rehabilitation services, and women’s health. 

Department: PFS - Revenue Enhancement

Status: Full-Time

Union/ Non-union: Non-Union

Job Summary:

The Managed Care Variance Collector is responsible for ensuring correct payments from payers with the goal of identifying payment variance and billing process issues to improve collections and cash receivables for AHN.

Job Responsibilities:

• Conducts comprehensive analytic reviews on denied patient accounts to determine if an appeal or retro review is warranted. (30%)
• Identifies and prevents denial patterns with internal teams and payers. (25%)
• Reviews payments, performs audits, adjusts accounts, and handles appeals process. (25%)
• Coordinates with other departments to resolve payer and customer issues. (15%)
• Demonstrates the ability to escalate issues to management as needed. (5%)
• Performs other duties as assigned or required.

Required Qualifications:

• 5 years of hospital billing, coding, and/or financial analytics experience required.
• Must be able to manage workloads and resources; must be able to function in a dynamic environment subject to impromptu changes in schedules and priorities, remaining calm in difficult situations; must have strong interpersonal skills.
• Follows standard and/or other appropriate precautions using personal protective equipment as required.