Eventhea Bufi Email & Phone Number

New York, Ny, Us

United States

Review claim & payment data through contract management systems to identify potential underpayments and payment variance trends, while ensuring contract systems are accurately updated with applicable rates/terms. Familiarity with hospital managed care contracts to determine appropriate application of rates, provisions and terms in comparison to reimbursement received.Calculation validation (Proration of contractual rates)Contract analysis to provide feedback surrounding… Show more Review claim & payment data through contract management systems to identify potential underpayments and payment variance trends, while ensuring contract systems are accurately updated with applicable rates/terms. Familiarity with hospital managed care contracts to determine appropriate application of rates, provisions and terms in comparison to reimbursement received.Calculation validation (Proration of contractual rates)Contract analysis to provide feedback surrounding improvement areas in current contract terms for future contract negotiations.Educates the Managed Care Analysis team and acts as a knowledge and experience resource for the department.Maintains personal knowledge base of current managed care trends, reimbursement methodologies, and other important third party payment factorsProvides client contract specific feedback, intelligence, and trends to Directors for regularly scheduled client calls and meetings. Show less

Review claim and payment information through contract management and underpayment identification systems to identify potential individual underpayments and underpayment trends.Review hospitals managed care contracts to determine appropriate application of rates, provisions and terms.Analysis of use of variance reports to review potential missed underpayment opportunities

Review hospital managed care contracts to determine appropriate application of rates, provisions and terms. Identify potential underpayment trends through comparison of managed care contracts to actual reimbursement information via contract management systems. Analyze trends to identify any bulk contract issues & removal of false positives. Process enables other team members to accurately and efficiently pursue lost revenue.

Oversee the day to day supervision of a team of Patient Account RepresentativesAct as a technical expert in regards to financial class responsibility, to answer questions raised by clients and team members in regards to reimbursement methodologies (APR DRG, facility rate based reimbursement)Analyze & report any detected trends in payments or denials, as well as procedural problems, to the client. Provide recommendations regarding the correction of these trends and/or problems should… Show more Oversee the day to day supervision of a team of Patient Account RepresentativesAct as a technical expert in regards to financial class responsibility, to answer questions raised by clients and team members in regards to reimbursement methodologies (APR DRG, facility rate based reimbursement)Analyze & report any detected trends in payments or denials, as well as procedural problems, to the client. Provide recommendations regarding the correction of these trends and/or problems should also be reported.Maintain a current working knowledge of all healthcare related issues and regulationsPrepare various reports or logs as required: cash reports, denial reports, trending/issue reportsKnowledge of governmental, legal and regulatory provisions related to collection activity. Show less