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Contract Compliance Spec - PFS NW Business Support - Miamisburg - FT / Days

Contract Compliance Spec - PFS NW Business Support - Miamisburg - FT / Days

Kettering Health NetworkMiamisburg, OH, US
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Job Title

Kettering Health is a not-for-profit system of 13 medical centers and more than 120 outpatient facilities serving southwest Ohio. We are committed to transforming the health care experience with high-quality care for every stage of life. Our service-oriented mission is in action every day, whether it's by providing care in our facilities, training the next generation of health care professionals, or serving others through international outreach.

Campus Overview

Kettering Health Miamisburg

  • 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)

Responsibilities & Requirements

Responsibilities :

  • 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.

    • Requirements :

  • 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.
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    Contract Compliance • Miamisburg, OH, US

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