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.

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 10^th 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)

Responsibilties:

• Experience with managed care contract terms and federal payer guidelines · Experience with medical necessity guidelines for CMS and various payers. · Experience with hospital billing (UB04 and 1500 forms) and coding requirements
• Epic Microsoft Products Strong analytical ability and critical thinking skills required
• Creative problem-solving skills 
• Ability to meet deadlines 
• Self-directed and organized 
• Personable, tactful and cooperative 
• Ability to work well with others 
• Ability to clearly communicate with and establish and maintain good rapport with physicians, hospital administration, nurses and other healthcare team members required 
• Demonstrate integrity and objectivity required
• Reviewing and specializing in CMS and payer policy guidelines and requirements. This will occur on a monthly basis.
• Streamlining operations of denials team to ensure optimal productivity with a high success rate in appeal turnovers.
• Regular meetings with the team including audits of team member appeals.
• Regular meetings with revenue generating departments to assist in streamlining operations to reduce denials. 
• Meeting with payers to address areas of concern and inefficiency resulting in delays to accounts. If items are not resolved in timely manner, escalating to next level for resolution.
• Review operational reports & complete AR analysis on a daily, weekly, monthly or as necessary basis of key performance indicators (KPIs), making necessary adjustments to staff resources, work flows or prioritization of work in order to reach the departments stated goals. 
• Develop department policies and procedures and coordinate with other departments to develop and maintain policies and procedures affecting the goals and objectives of the team and the entire revenue cycle.
• Working with denial vendors contracted through KHN to ensure operations performs to KHN standards

Requirements:

• Minimum of 3 years billing or 2 years revenue cycle denial experience
• One-year management experience