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Are you looking to take your career to new heights with a leader in healthcare? SUNY Downstate Health Sciences University is one of the nation's leading metropolitan medical centers. As the only academic medical center in Brooklyn, we serve a large population that is among the most diverse in the world. We are also highly-ranked by Castle Connolly Medical, a healthcare rating company for consumers, among the top 5 leading U.S. medical schools for training doctors.
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Bargaining Unit:
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UUP
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Job Summary:
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The Department of Hospital Finance at SUNY Downstate Health Sciences University is seeking a full-time Physician Compensation & Billing Director.
Duties and Responsibilities to Include:
Physician Compensation
- Compensation Analysis:
- Analyze and evaluate physician compensation plans to ensure they are competitive, fair, and aligned with organizational goals.
- Benchmark physician compensation against industry standards, using survey data and other sources to inform decision-making.
- Prepare detailed compensation reports and present findings to management.
- Plan Design and Implementation:
- Assist in designing and implementing compensation programs, including base salary, incentive plans, bonuses, and benefits.
- Ensure that compensation plans are structured to meet regulatory requirements (e.g., Stark Law,
- Anti-Kickback Statute) and align with organizational policies.
- Develop models and scenarios to assess the financial impact of compensation changes.
- Compliance and Documentation:
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- Ensure that all physician compensation practices comply with federal and state laws and regulations.
- Maintain detailed records of compensation plans, contracts, and related documentation.
- Participate in internal audits and reviews to ensure compliance with compensation policies.
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- Identify opportunities for improving compensation processes and programs.
- Stay informed about trends in physician compensation, regulatory changes, and best practices.
Physician Billing
- Billing and Coding:
- Review and verify the accuracy of medical coding (CPT, ICD-10) in physician documentation.
- Submit claims to insurance companies and government payers (Medicare, Medicaid) for services rendered.
- Ensure that all billing complies with applicable regulations and guidelines, including the use of correct codes and modifiers.
- Claim Management:
- Monitor and follow up on unpaid or denied claims, ensuring timely resolution.
- Investigate and correct claim rejections or denials by coordinating with insurance companies, patients, and healthcare providers.
- Resubmit claims with necessary corrections or additional documentation.
- Patient Billing:
- Prepare and send patient bills for any outstanding balances not covered by insurance.
- Respond to patient inquiries regarding their bills, providing clear explanations and resolving billing disputes.
- Assist patients with setting up payment plans as needed.
- Compliance and Auditing:
- Stay updated on changes in billing regulations, coding guidelines, and payer policies.
- Participate in internal and external audits to ensure billing accuracy and compliance.
- Implement corrective actions to address any identified discrepancies or non-compliance issues.
- Reporting:
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- Generate and analyze reports on billing activities, such as aging reports and revenue cycle metrics.
- Provide feedback to management on trends in denials, delays, or other issues impacting revenue.
- Collaboration:
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- Work closely with physicians, clinical staff, and other departments to ensure accurate and efficient billing processes.
- Educate physicians and staff on documentation requirements and billing best practices.
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Required Qualifications:
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- Bachelor's Degree in Healthcare Administration, Business Administration, or a related field.
- Minimum of 5 years of experience in physician compensation and physician billing.
- Or education, training and/or experience equivalent to above.
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Preferred Qualifications:
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Work Schedule:
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Monday to Friday; 9:00am to 5:00pm (Full-Time)
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Salary Grade/Rank:
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SL-6 |
Salary Range:
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Commensurate with experience and qualifications
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Executive Order:
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Pursuant to Executive Order 161, no State entity, as defined by the Executive Order, is permitted to ask, or mandate, in any form, that an applicant for employment provide his or her current compensation, or any prior compensation history, until such time as the applicant is extended a conditional offer of employment with compensation. If such information has been requested from you before such time, please contact the Governor’s Office of Employee Relations at (518) 474-6988 or via email at info@goer.ny.gov.
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Equal Employment Opportunity Statement:
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SUNY Downstate Health Sciences University is an affirmative action, equal opportunity employer and does not discriminate on the basis of race, color, national origin, religion, creed, age, disability, sex, gender identity or expression, sexual orientation, familial status, pregnancy, predisposing genetic characteristics, military status, domestic violence victim status, criminal conviction, and all other protected classes under federal or state laws.
Women, minorities, veterans, individuals with disabilities and members of underrepresented groups are encouraged to apply.
If you are an individual with a disability and need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please contact Human Resources at ada@downstate.edu
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