02/20/2019

Digestive Health Associates is hiring a full-time Billing Manager. We offer employees competitive wages, paid holidays, and paid time off. Employees can expect no night, weekend, or holiday shifts. In addition, full-time employees are also eligible for a generous 401k profit sharing plan. Please send resume to kariv@digesthealth.com 

GENERAL SUMMARY: The Billing Manager functions in a working Manager role to ensure timely and accurate charge entry and follow-up on unpaid claims and denials.  In addition to medical billing duties, patient A/R is included when working with established patient statement and collection companies.  This position is responsible for Managing a Team that consists of an A/R Specialist, Inpatient/Outpatient Billers, Prior Authorization obtainer, payment poster, and other Administrative duties. The Billing Manager reports to the Practice Administrator and Managing Physician Partners.

Education: Minimum: High School graduate. Working knowledge of medical terminology as well as procedural and diagnosis coding is required

Preferred: Higher education with a medical office or account focus. Certified Professional Coder (CPC), Certified Professional Biller (CPB) or Certified Revenue Cycle Specialist-Professional (CRCS-P) preferred

Work Experience: Minimum: One year of recent, relevant experience with accounts receivable follow-up and/or denials management experience.

Preferred: Two or more years of recent, relevant experience with accounts receivable follow-up and/or denials management experience; experience with working in eClinical Works.

Professional Skills:

Communication: Effective verbal and written skills, computer literate

Customer Service: Patient confidentiality, helpful, patience Organizational: Detail oriented, problem-solving abilities, efficient Team Leader Skills: Demonstrate the ability and willingness to work as an effective part of a team and to lead a team.

DUTIES AND RESPONSIBILITIES:

1. Account Follow-Up and Denials Management Skills Demonstrate ability to follow internal policies and procedures regarding follow-up timelines and methods, documentation standards and spreadsheet creation and maintenance as assigned Maintain a working knowledge of 835 and 277 rejection and denials reason codes (Remittance Advice Remark Codes (RARC) and Claim Adjustment Reason Codes (CARC)) along with payer specific adjustment and denial codes. Write and follow-up on appeal letters for denied claims referencing any applicable research, medical record documentation, medical policy and/or coding and billing rules Use payer websites, payer inquiry methods, payer representatives and other applicable payer specific methods to obtain prompt payment of claims and identification and resolution of any issues affecting prompt payment Use aging reports, work queues, tasks, ticklers and other follow-up techniques to ensure timely follow-up of unpaid claims and timely follow-up on claims that have been underpaid or denied Effectively manage accounts receivable within area of assignment
2. Administrative Skills Handle incoming and outgoing correspondence. Provide telephone support for patients and insurance carriers. Communicate with others on the team including cash posters and leadership regarding payers not meeting contractual obligations pertaining to timely payment, denials, and any trends or outliers noted Communicate with on-site clinic staff regarding medical documentation needs
3. Quality Management Adhere to corporate compliance and HIPAA standards and policies Use relevant knowledge of carrier issues, medical policies and billing standards to ensure accurate and timely payments (know when to question) Participate in peer review, quality management and outcome studies as assigned Follow standards, policies, and procedures to make appropriate adjustments
4. Facilities/Equipment Demonstrate working knowledge of equipment Coordinate with appropriate person for repairs or maintenance Follow established appropriate use standards
5. Self-improvement/Professional Activities Keep current on issues, practice patterns and trends in medical billing and those specific to pain management Attend continuing education specific to job duties Promote staff development activities and program goals and objectives 

PHYSICAL DEMANDS: Independently mobile to perform job tasks Approximately 99% of time sent sitting Moderate to heavy computer use Able to lift up to 30 pounds

WORKING CONDITIONS: Fast paced, demanding office environment Exposure to a variety of attitudes and personalities from patients and visitors Multiple interruptions

02/04/2019

The individual is responsible for designing, monitoring, implementing and enforcing policies and procedures, as well as streamlining effective billing processes across multiple locations.

This position is highly visible and requires a strong managerial, leadership and business office skills with the ability to prioritize, plan, coach and direct.

• Maintains effective communication and working relationship with all company personnel, demonstrates leadership and analytical abilities.
• Ensures the maintenance of all appropriate billing records to meet legal and regulatory requirements.
• Maintains a working knowledge of all billing policies, procedures, rules and regulations; update appropriate staff of changes.
• Maintains a working knowledge of all revenue cycle management computer systems; works with internal IT staff and external software vendor to stay current with changes in technology; ensures all payer information is set up correctly.
• Prepares and analyzes accounts receivable reports, weekly and monthly financial reports, and insurance contracts. Collects and compiles accurate statistical reports

Education, Experience, Skills and Qualifications:

• High School Diploma required, and BA/BS in Accounting/Finance or related Business Degree preferred
• Minimum 5 years’ experience in Healthcare setting.
• Significant prior revenue cycle management and governmental payer requirements and regulations
• Extreme attention to detail and superior oral and written communication skills.
• Advanced computer skills on Allscripts Pro, Payerpath, MS Office, and databases.
• Ability to direct and supervise with strong problem-solving skills.

No Phone Calls. Please apply online at Rehmann/HUC website: https://app.jobvite.com/j?cj=ozBm9fwp&s=MMBA

02/04/2019

Characteristics of a successful candidate will include strong coding and billing skills, an advocate of a positive patient experience, commitment to achieving performance measures, high level of energy and self-motivation, and a dependable professional with a desire to work in a team setting.

Your responsibilities will include:

• Analyze and interpret medical records to identify and assign CPT and ICD10 codes on all billable services.
• Create billing batches and enter data to create claims for submission to insurance companies.
• Follow coding guidelines and legal requirements to ensure compliance with federal and state regulatory bodies
• Appeal insurance denials when appropriate
• Audit medical records to ensure proper coding completed and to ensure compliance with federal and state regulatory bodies
• Teach physicians billing guidelines
• Review patient records and recommend appropriate coding/documentation for deficient records.
• Maintain compliance standards in accordance with the Compliance policies and Code of Conduct
• Familiarity with all major coding resources
• Ability to audit, track, compile and analyze statistical data

If interested, please visit our website www.regcardiology.com to apply

02/04/2019

The Billing & Follow-Up Representative reviews, researches, and processes claims in accordance with contracts and policies to determine the extent of liability and entitlement, as well as to adjudicate claims as appropriate. The core responsibilities will include: coding and processing claim forms; reviewing claims for complete information, correcting and completing forms as needed; accessing information and translating data into information acceptable to the claims processing system; and preparing claims for return to provider/subscriber if additional information in needed.

Additional follow-up responsibilities include: maintaining all appropriate claims files and following up on suspended claims; assisting, identifying, researching and resolving coordination of benefits, subrogation, and general inquiry issues, then communicating the results; and preparing formal history reviews.

ESSENTIAL FUNCTIONS: Knows, understands, incorporates, and demonstrates the Trinity Health Mission, Vision, and Values in behaviors, practices, and decisions. Submits 3rd party and patient claims (electronically or by hard copy), including the maintenance of bill holds and the correction of errors in an effort to provide timely, accurate billing services. Edits UB-04 (and where appropriate HCFA-1500) claim forms within the patient accounting system, using proper data element instructions for each payer, applying principles of coordination of benefits, and ensuring that correct ICD-10 diagnosis, HCPCS and CPT procedure codes are utilized. Ensures that claims are in accordance with regulations set forth by the state and federal governments, 3rd party payers, and Trinity Health guidelines. Performs all billing and follow-up functions, including the investigation of over-payments, underpayments, payment delays resulting from denied, rejected and/or pending claims, with the objective of appropriately maximizing reimbursement based upon services delivered and ensuring that the claim is paid/settled in the most timely manner. These functions will be in coordination with the Central Operations team, depending on threshold metrics defined by work queues for the Shared Service Centers and Central Operations. Utilizes available data and resources to make decisions regarding complexity of claim processing and payment propensity, and the appropriateness of transferring account to the Disputed Claims Management team, Collection vendor(s) or other resources for follow-up; Researches claim rejections, making corrections, taking corrective actions and/or referring claims to appropriate staff members for follow through to ensure timely claim resolutions;

Proactively follows-up on delayed payments by contacting patients and 3rd party payers, and supplying additional data, as required; May perform financial counseling activities, including but not limited to: Seeks appropriate funding based upon patient requirements, collecting supporting documentation (payroll stubs, tax returns, credit history, etc.), as required. Provides information and education to the patient, family member and/or guarantor of the application/documentation process.

In so doing, the incumbent will encourage patient participation in the funding process and will assist the patient in forwarding the required documentation and application to the appropriate funding agency:  Counsels patient/guarantor on patient’s financial liability, third party payer requirements and outside financial resources, including private organizations and foundations, eligibility vendor(s), Medicaid, Medicare, Champus, and/or federal disability programs, etc.; Counsels patient/guarantor of payment plan options and establishes appropriate plan; Investigates No Fault and Workers’ Compensation cases, retrieving police report and insurance information, as required; Assists patient/guarantor in completing a charity application, financial statement and/or payment contract when required according to hospital policies. Analyzes such applications along with income/resident documentation in order to advise the patient of available options. Initiates requests for charity write-off, when appropriate; Analyzes financial and eligibility data, and length of disability to determine potential eligibility for federal, state, and/or county programs, completing the necessary documents within the time limits specified by the appropriate government agency; Determines and manages proper course of action for optimal reimbursement of healthcare charges (e.g., spend down eligibility, out-of-network, Cobra coverage, etc.); and Informs patient/guarantor of flat-rate and discount programs and assists patient in application process, ensuring that adjustments are requested and completed. Evaluates accounts, resubmits claims, and performs refunds, adjustments, write-offs and/or balance reversals, if charges were improperly billed or if payments were incorrect; and Updates and refiles claim forms in a timely, accurate manner. Responds to patient and 3rd party payer inquiries (telephone, fax, mail and web-based patient portal), complaints or issues regarding patient billing and collections, either responding directly or referring the problem to an appropriate resource for resolution. Communicates with physicians and their office staff, Patient Access, Medical Records/Health Information Management, Utilization Review/Case Management, Managed Care, Ancillary and Nursing staff, as required to clarify billing discrepancies, and obtain demographic, clinical, financial and insurance information. May prepare special reports as directed by the Manager to document billing and follow-up services (e.g., Number of claims and dollars billed, number of claims edited, number of claims unprocessed, etc.). May serve as relief support, if the work schedule or workload demands assistance to departmental personnel.

May also be chosen to serve as a resource to train new employees. Cross- training in various functions is expected to assist in the smooth delivery of departmental services.

Other duties as needed and assigned by the manager. Maintains a working knowledge of applicable Federal, State, and local laws and regulations, Trinity Health’s Organizational Integrity Program, Standards of Conduct, as well as other policies and procedures in order to ensure adherence in a manner that reflects honest, ethical, and professional behavior.

MINIMUM QUALIFICATIONS: High school diploma or an equivalent combination of education and experience. Associate degree in accounting or business administration high desired. Data entry skills (50-60 keystrokes per minutes). Past work experience of at least one year within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing medical claims processing, financial counseling, financial clearance and/or customer service activities is required. Knowledge of insurance and governmental programs, regulations and billing processes (e.g., Medicare, Medicaid, Social Security Disability, Champus, Supplemental Security Income Disability, etc.), managed care contracts and coordination of benefits is required. Working knowledge of medical terminology, anatomy and physiology, medical record coding (ICD-10, CPT, HCPCS), and basic computer skills are highly desirable. Excellent communication (verbal and writing) and organizational abilities. Interpersonal skills are necessary in dealing with internal and external customers. Accuracy, attentiveness to detail and time management skills are required. To successfully accomplish the essential job functions of this position, the incumbent will be required to work independently, read, write, and operate keyboard and telephone effectively. Must be comfortable operating in a collaborative, shared leadership environment. Must possess a personal presence that is characterized by a sense of honesty, integrity, and caring with the ability to inspire and motivate others to promote the philosophy, mission, vision, goals, and values of Trinity Health.

PHYSICAL AND MENTAL REQUIREMENTS AND WORKING CONDITIONS: Must be able to set and organize own work priorities, and adapt to them as they change frequently. Must be able to work concurrently on a variety of tasks/projects in an environment that may be stressful with individuals having diverse personalities and work styles. Excellent problem solving skills are essential. This position requires the ability to comprehend and retain information that can be applied to work procedures to achieve appropriate service delivery. The greatest challenge in this position is to ensure that billing and follow-up activities are performed promptly and in an accurate manner to assist in order to reduce potential financial loss to the patient and the Ministry Organization. The incumbent must have a thorough knowledge of various insurance documentation requirements, the patient accounting system, and various data entry codes to ensure proper service documentation and billing of the patient's account. Position operates in an office environment. Work area is well-lit, temperature controlled and free from hazards. The incumbent is subject to eyestrain due to the many hours spent looking at a CRT screen. The noise level is low to moderate. Completion of regulatory/mandatory certifications and skills validation competencies preferred. Must possess the ability to comply with Trinity Health policies and procedures.

Trinity Health's Commitment to Diversity and Inclusion Trinity Health employs about 133,000 colleagues at dozens of hospitals and hundreds of health centers in 22 states. Because we serve diverse populations, our colleagues are trained to recognize the cultural beliefs, values, traditions, language preferences, and health practices of the communities that we serve and to apply that knowledge to produce positive health outcomes. We also recognize that each of us has a different way of thinking and perceiving our world and that these differences often lead to innovative solutions.

Trinity Health's dedication to diversity includes a unified workforce (through training and education, recruitment, retention and development), commitment and accountability, communication, community partnerships, and supplier diversity.

Email resume to: Cynthia.marshall-gillom@trinity-health.org

01/24/2019

ProCare Pain Solutions is hiring a full-time Accounts Receivable and Denials Management Specialist for our growing downtown Grand Rapids location. We offer employees competitive wages, paid holidays, and paid time off. Employees can expect no night, weekend, or holiday shifts. In addition, full-time employees are also eligible for a generous 401k profit sharing plan after one year of service. Please send resume to hr@procarepain.com for consideration. Thank you!

GENERAL SUMMARY: The Accounts Receivable and Denials Management Specialist functions in an administrative role to ensure timely and accurate follow-up on unpaid claims and denials. This position is responsible for following up on all outstanding accounts which includes reviewing outstanding A/R reports, outstanding accounts in follow-up queues and identifying and reporting trends and changes in payments and denials. The account receivable specialist works under the direction of and reports to the billing team leader.

Education: Minimum: High School graduate. Working knowledge of medical terminology as well as procedural and diagnosis coding is required

Preferred: Higher education with a medical office or account focus. Certified Professional Coder (CPC), Certified Professional Biller (CPB) or Certified Revenue Cycle Specialist-Professional (CRCS-P) preferred

Work Experience: Minimum: One year of recent, relevant experience with accounts receivable follow-up and/or denials management experience.

Preferred: Two or more years of recent, relevant experience with accounts receivable follow-up and/or denials management experience; experience with working in eClinical Works or Centricity preferred

Professional Skills:

Communication: Effective verbal and written skills, computer literate

Customer Service: Patient confidentiality, helpful, patience Organizational: Detail oriented, problem solving abilities, efficient Team Skills: Demonstrate ability and willingness to work as an effective part of a team CHARACTERISTIC

DUTIES AND RESPONSIBILITIES:

1. Account Follow-Up and Denials Management Skills Demonstrate ability to follow internal policies and procedures regarding follow-up timelines and methods, documentation standards and spreadsheet creation and maintenance as assigned Maintain a working knowledge of 835 and 277 rejection and denials reason codes (Remittance Advice Remark Codes (RARC) and Claim Adjustment Reason Codes (CARC)) along with payer specific adjustment and denial codes. Write and follow-up on appeal letters for denied claims referencing any applicable research, medical record documentation, medical policy and/or coding and billing rules Use payer websites, payer inquiry methods, payer representatives and other applicable payer specific methods to obtain prompt payment of claims and identification and resolution of any issues affecting prompt payment Use aging reports, work queues, tasks, ticklers and other follow-up techniques to ensure timely follow-up of unpaid claims and timely follow-up on claims that have been underpaid or denied Effectively manage accounts receivable within area of assignment

2. Administrative Skills Handle incoming and outgoing correspondence Provide telephone support for patients and insurance carriers Communicate with others on team including cash posters and leadership regarding payers not meeting contractual obligations pertaining to timely payment, denials and any trends or outliers noted Communicate with on-site clinic staff regarding medical documentation needs

3. Quality Management Adhere to corporate compliance and HIPAA standards and policies Use relevant knowledge of carrier issues, medical policies and billing standards to ensure accurate and timely payments (know when to question) Participate in peer review, quality management and outcome studies as assigned Follow standards, policies and procedures to make appropriate adjustments

4. Facilities/Equipment Demonstrate working knowledge of equipment Coordinate with appropriate person for repairs or maintenance Follow established appropriate use standards

5. Self-improvement/Professional Activities Keep current on issues, practice patterns and trends in medical billing and those specific to pain management Attend continuing education specific to job duties Promote staff development activities and program goals and objectives 

PHYSICAL DEMANDS: Independently mobile to perform job tasks Approximately 99% of time sent sitting Moderate to heavy computer use Able to lift up to 30 pounds

WORKING CONDITIONS: Fast paced, demanding office environment Exposure to a variety of attitudes and personalities from patients and visitors Multiple interruptions