Qureos Mentor

Mount Nittany Health

<div>POSITION SUMMARY
The Revenue Recovery Analyst is responsible for identifying, analyzing, and resolving hospital and physician payment variances to ensure accurate reimbursement and support enterprise revenue integrity objectives. This role performs both account-level recovery activities and population-level analytics to detect underpayment and overpayment trends, validate contract compliance, and support proactive mitigation of revenue leakage.
The Analyst partners closely with the Manager of Reimbursement, Revenue Integrity, Patient Accounts, and Finance to support expected reimbursement accuracy, payer performance monitoring, and root cause remediation. This position plays a key role in preparing the organization for Epic expected reimbursement functionality and advancing data-driven reimbursement strategy. 
MINIMUM REQUIREMENTS
Education:
<div><ul><li>Bachelor&rsquo;s degree in Healthcare Administration, Finance, Business, or related field preferred
</li></ul><ul><li>Equivalent combination of education and relevant experience considered
</li></ul></div>Experience:
<div><ul><li>Minimum 3&ndash;5 years healthcare revenue cycle experience preferred
</li></ul><ul><li>Demonstrated experience in underpayment or payment variance analysis preferred
</li></ul><ul><li>Experience working with hospital and/or outpatient reimbursement preferred
</li></ul><ul><li>Familiarity with government and commercial payer methodologies preferred
</li></ul></div>Knowledge, Skills, Abilities:
<ul><li>Strong understanding of hospital and outpatient reimbursement methodologies
</li><li>Ability to interpret payer contracts and remittance advice
</li><li>Advanced analytical and problem-solving skills
</li><li>Proficiency in Excel (pivot tables, lookups, data analysis)
</li><li>Experience with revenue cycle systems (Meditech, Epic, Quadax, or similar) preferred
</li><li>Knowledge of UB-04 and/or CMS-1500 claim structure preferred
</li><li>Strong attention to detail and organizational skills
</li><li>Ability to manage multiple priorities and meet deadlines
</li><li>Effective written and verbal communication skills
</li><li>Ability to work both independently and collaboratively
</li><li>Knowledge of CPT and HCPCS codes preferred.
</li></ul>License/Certification/Registration:
None required
SUPERVISION RECEIVED
Receives primary supervision from the Manager Reimbursement under the leadership of Director of Revenue Integrity &amp; Reimbursement Strategy.
SUPERVISION GIVEN
None</div>
 <div>ESSENTIAL FUNCTIONS
Payment Variance Identification &amp; Recovery
<ul><li>Identify and resolve underpayments and overpayments across government and commercial payers
</li><li>Perform detailed account reviews comparing expected vs. actual reimbursement
</li><li>Initiate and manage payer appeals and refund processes in accordance with regulatory requirements
</li><li>Track and document recovery activity, outcomes, and aging
</li><li>Escalate complex payer issues to Manager of Reimbursement as appropriate
</li><li>Ensure timely and compliant resolution of payment discrepancies
</li><li>Monitor payer reimbursement policies, bulletins, and payment methodology updates to identify potential financial impact. Perform preliminary analysis and escalate material changes to reimbursement leadership for further evaluation and action.
</li></ul>Analytics, Trending &amp; Root Cause
<ul><li>Develop and maintain reports to monitor reimbursement performance by payer, service line, CPT/HCPCS, and DRG
</li><li>Perform population-level analysis to identify systemic payment issues and emerging trends
</li><li>Conduct root cause analysis and partner with Revenue Integrity, Patient Accounts, and Contracting to implement corrective actions
</li><li>Quantify revenue at risk and recovery opportunities
</li><li>Monitor payer compliance with contractual reimbursement terms
</li><li>Identify opportunities for process improvement and automation
</li></ul>Expected Reimbursement &amp; Contract Support
<ul><li>Support validation of expected reimbursement models and payer payment logic
</li><li>Assist in maintaining payer rate tables and reimbursement assumptions
</li><li>Provide data support for payer discussions and dispute resolution
</li><li>Assist with Epic expected reimbursement readiness and ongoing optimization
</li></ul>Reporting &amp; Collaboration
<ul><li>Prepare recurring and ad hoc reports for reimbursement leadership
</li><li>Communicate trends and risks to Manager of Reimbursement and Director of Revenue Integrity &amp; Reimbursement Strategy
</li><li>Collaborate with Revenue Integrity, Patient Access, Coding, and Patient Accounts to resolve upstream and downstream issues
</li><li>Support development of dashboards and performance monitoring tools
</li><li>Participate in cross-functional initiatives to improve revenue cycle performance
</li></ul>Compliance &amp; Regulatory
<ul><li>Ensure adherence to payer contract terms and regulatory requirements
</li><li>Maintain compliance with Medicare, Medicaid, and commercial payer guidelines
</li><li>Support audit readiness and documentation standards
</li><li>Stay current on reimbursement rule changes and payer policy updates
</li></ul>NON-ESSENTIAL FUNCTIONS
Performs related and miscellaneous duties as assigned.</div>

Revenue Recovery Analyst

<div>POSITION SUMMARY
Provide professional nursing care to patients following established standards, practices and healthcare techniques. Demonstrate competence in making professional judgments pertaining to patient care. Assist providers in patient care and education. Actively participates as a member of the healthcare team to engage patients, families, and caregivers in the coordination of patient care.
MINIMUM REQUIREMENTS
Education:
<div><ul><li>Graduate of an accredited school of nursing.
</li></ul></div>Experience:
<div><ul><li>One year nursing experience preferred.
</li></ul></div>Knowledge, Skills, Abilities:
Knowledge of the practical nursing principles and skills needed to provide quality patient care and treatment including examination, diagnostic and treatment procedures, medications effects on patients and patient education principles. Knowledge of common safety hazards and precautions. Knowledge of office procedures and medical terminology. Basic knowledge of ICD-10 and CPT coding guidelines. Ability to communicate clearly and effectively and read, understand and follow written and verbal instructions of the physician. Must be able to react calmly and effectively during emergency situations. Must have the ability to identify and analyze problems, prioritize, make confident quick decisions and recommend effective solutions. Ability to administer a variety of medications and treatments and utilize various types of equipment for examination and treatment procedures.
License/Certification/Registration:
<div><ul><li>Pennsylvania Registered Nurse license.
</li></ul><ul><li>Meets the American Heart Association&rsquo;s standards for Healthcare Provider Basic Life Support (BLS) and renews BLS every two years.
</li></ul></div>WORKING CONDITIONS
Fast paced, stressful, high traffic medical office. May be exposed to communicable diseases, toxic substances, medicinal preparations, bodily fluids and other conditions common to a clinic environment. May require working irregular hours. May require travel to other offices.
PHYSICAL DEMANDS
Requires full range body motion including handling and lifting patients, manual and finger dexterity and hand-eye coordination. May require sitting, standing and walking for extended periods of time. Occasional lifting and carrying of items weighing up to 50 pounds. Requires corrected vision and hearing to normal range.</div>
 ESSENTIAL FUNCTIONS
Perform patient assessment of medical condition required and report to physician or mid-level provider.
Provide general nursing care to patients. Administer prescribed medications and treatments in accordance with nursing standards under the direction of the provider.
Screen and prioritize patient telephone inquiries concerning their medical care, prescription refills, insurance authorizations and referrals and record information in patient chart.
Greet patients and prepare them for provider examination and treatment. Screen patients for appropriate information and observe, record and report patient&rsquo;s condition and reaction to drugs and treatments to the provider. Instruct patients in collection of samples and tests.
Prepare equipment and assist the provider during treatment, examination and testing of patients.
Provide appropriate education and instructions to the patient and family regarding medication and treatment protocol.
Perform and document various tests and procedures as directed by the provider. Document patient information, test and examination results and care provided in the patient&rsquo;s paper or electronic health record.
Evaluate and respond appropriately to urgent or emergency situations.
Timely and accurate documentation of care provided in the patient&rsquo;s medical record.
Participates in quality improvement activities and processes.
Contact patients to relate test results and care instructions, according to provider instructions.
Review laboratory results and other patient information.
Using the Electronic Health Record, document and bill for services rendered.
Coordinate patient referrals, appointments, testing and admissions to other facilities.
Call pharmacies with patient prescriptions according to provider&rsquo;s instructions and protocol.
Monitor and maintain clinical supplies for exam rooms. Ensure exam rooms are stocked, neat and orderly. Clean, sterilize and test medical equipment.
Obtain proper insurance company referral or authorization for required visits or testing.
Screen and refer pharmaceutical representatives.
Perform other duties as required.
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Registered Nurse MNPG General Surgery MNPG

POSITION SUMMARY
 
General Summary
 Primary function is to assist the Physical Therapist and the Physical Therapy Assistant in performing various treatment procedures. The Physical Therapy Technician will actively participate as a member of the healthcare team to engage patients, families, and caregivers in the coordination of patient care.
 
MINIMUM REQUIREMENTS
 
Education: 
Preference for those enrolled in undergraduate Kinesiology or other health related field of study. Clinical experience preferred.
 
Knowledge, Skills, Abilities: 
Must have strong communication skills and interpersonal skills. Demonstrates maturity to function independently, organize work and set priorities appropriately.
 
License/Certification/Registration: 
Must complete the American Heart Association’s Healthcare Provider Basic Life Support (BLS) and renew BLS every two years.
 
WORKING CONDITIONS
 
Normal office environment. Frequent contact with patients. May require working various shifts to ensure adequate coverage.
 
PHYSICAL DEMANDS
 
Requires full range body motion including handling patients, manual and finger dexterity and hand-eye coordination. May require standing and walking for extended periods of time. Occasional lifting and carrying of items weighing up to 50 pounds. Requires corrected vision and hearing to normal range.
 ESSENTIAL FUNCTIONS
 
Review patients diagnosis and review exercises and protocols prior to assisting patient
 Performs responsibilities in a manner, which demonstrates professionalism
 Ensure there are rooms ready to receive patients prior to appointments
 Know how to use all necessary equipment in the facility
 Have all necessary equipment ready for patient use
 Checks the treatment areas for proper arrangements of equipment on a daily basis and as needed during the day
 Provide proper demonstrations and verbal descriptions of exercises and stretches
 Be aware of signs and indicators to stop an individual exercise or stretch
 Prompt patients for feedback before, during and after exercises and stretches
 Provide positive feedback and encouragement to patients
 Document all interactions in TheraOffice
 Communicate with Physical Therapist’s as well as Physical Therapist Assistants about each patient’s session
 Maintains the physical orderliness of the facility
 Perform other duties as required
 
To perform this job successfully, an individual must be able to perform each essential function satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
 This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Physical Therapy Technician

Join Mount Nittany Health and explore 3   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Mount Nittany Health

About Company

Revenue Recovery Analyst

Registered Nurse MNPG General Surgery MNPG

Physical Therapy Technician