07/16/2018

The Business Services Manager for the AR Management Division manages the day-to-day operations of an assigned accounts receivable in order to ensure maximum collections and minimum write-offs. Provides leadership and works with staff regarding day-to-day issues to ensure efficient, fiscally responsible, and customer responsive operations. Manages and develops staff in order to maintain outstanding service and a high level of employee morale.

ESSENTIAL JOB FUNCTIONS: Leadership:

1. Together with the Director of Business Services, develops the vision and direction of the central billing office, and executes on that plan to achieve IHA's priorities and financial objectives.
2. In conjunction with the Director of Business Services, develops the vision and direction of the manager's oversight responsibilities, and executes on that plan to advance IHA's priorities and financial objectives.
3. Coordinates scheduling of staff to maintain appropriate staffing levels to meet accounts receivable coverage and financial goals.
4. Coordinates and contributes as appropriate to staff and central billing office improvement plans.
5. Under the guidance of the Director of Business Services, organize and implement an orientation program for all new staff.
6. Promotes education opportunities for staff.
7. Identifies and develops future leadership within the department.
8. Evaluates staff satisfaction data and develops improvement work plans. Manages the implementation of improvement plans and measures results.
9. Maintains knowledge of IHA human resources, and responds to employee and customer needs appropriately.
10. Maintains teamwork environment and a high level of employee morale.
11. Assists with special projects as needed.

Management:
1. Ensure adequate training is available to staff.
2. Recruits, selects, trains/orients and manages accounts receivable personnel, in accordance with IHA service and human resource guidelines.
3. Ensure adequate time and support for staff in order to meet financial objectives.
4. Work with staff managers, Director of Business Services and HR to address personnel issues.
5. Work closely with the Director of Business Services to ensure that IHA employees are of the appropriate skill level, educational and experiential backgrounds, and other qualifications.
6. The Business Services Manager, in conjunction with the Director of Business Services assures that all office personnel know, understand, and perform their duties in accordance with IHA's mission and its core values of commitment, advocacy, respect, efficiency and service.
7. Evaluates the performance of staff and recommends merit increases, promotions and disciplinary actions, in accordance with IHA Human Resource and service guidelines.
8. Works closely with staff to develop and implement performance goals and objectives.
9. Manages special projects as needed.

ESSENTIAL QUALIFICATIONS: EDUCATION: Bachelor's degree or equivalent combination of education and professional experience.

CREDENTIALS/LICENSURE: Certified Professional Coder (CPC) or Registered Health Information Technician (RHIT) preferred.

MINIMUM EXPERIENCE: Minimum 5 years' experience in the health care industry with an emphasis on medical billing required. 1 year prior supervisory experience. Knowledge in one or more areas of business services which may include: insurance verification; accessing payer sites, medical coding and billing, charge entry, AR claims follow-up, payment posting, patient financial services and customer service.

POSITION REQUIREMENTS (ABILITIES & SKILLS):
1. Demonstrated ability to work independently and to effectively supervise and manage functional area within the team, support more complex issues, and provide feedback and guidance to staff.
2. Knowledge of fiscal management practices, health care administration systems, insurance billing and coding, insurance verification, accessing payer sites, charge entry, AR claims follow-up, payment posting, patient financial services, customer service and organizational policies related to position responsibilities.
3. Ability to analyze and interpret financial and other performance data.
4. Proficient/knowledgeable in medical terminology related to job duties.
5. Ability to perform mathematical calculations needed during the course of performing basic job duties. 6. Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, electronic medical records, email, e-learning, intranet, Microsoft Word and Excel, and computer navigation. Ability to use other software as required while performing the essential functions of the job.
7. Excellent communication skills in both written and verbal forms, including proper phone etiquette. Ability to speak before groups of people.
8. Ability to work collaboratively in a team-oriented environment; courteous and friendly demeanor.
9. Ability to work effectively with various levels of organizational members and diverse populations including IHA staff, providers, patients, family members, insurance carriers, vendors, external customers and community groups.
10. Ability to cross-train in other areas of practice in order to achieve smooth flow of all operations.
11. Good organizational and time management skills to effectively juggle multiple priorities and time constraints.
12. Ability to exercise sound judgment and problem-solving skills, specifically as it relates to resolving routine to complex issues.
13. Ability to handle patient and organizational information in a confidential manner.
14. Knowledge of the compliance aspects of clinical care and patient privacy and best practices in medical office operations.
15. Successful completion of IHA competency-based program within introductory and training period.

Please view our web site at IHACares.com - careers

07/16/2018

Please apply at: https://www.healthcaresource.com/ihath/index.cfm?fuseaction=search.jobDetails&template=dsp_job_details.cfm&cJobId=102972 

Bachelor's Degree Cert Professional Coder (CPC) Registered Health Information Technician (RHIT)

1 - 3 years of experience required

POSITION DESCRIPTION:
Performs medical record audits to ensure accurate assessment of external or internal ICD-10-CM code selection and appropriate documentation to support.  The objective is to improve specificity and accuracy of diagnoses coding to show the true clinical condition of patients.

ESSENTIAL JOB FUNCTIONS:
1. Perform code abstraction and/or coding quality audits of medical records to ensure ICD-10-CM codes are accurately assigned and supported by clinical documentation.
2. Retrieves and/or performs electronic medical chart reviews.
3. Review and assign accurate medical codes for diagnoses performed by physicians and other qualified healthcare providers in the office or facility setting (e.g., inpatient hospital).
4. Verifies accuracy, completeness, and appropriateness of diagnosis codes based on basic to moderately complex medical documentation provided.
5. Identify and communicate documentation deficiencies to providers to improve documentation for accurate risk adjustment coding.
6. Uses data analysis and language software to identify opportunities and review for acceptance or rejection to modify a claim based on documentation and ICD 10-CM correct coding conventions.
7. Identifies and documents coding observations or discrepancies and provides information to management team to further enhance quality and/or provider education.
8. Performs medical record audits on external vendors risk adjustment work to ensure compliance with CMS and ICD 10 coding conventions.
9. Select correct ICD code assignment by proficient analysis and translation of diagnostic statements, physicians' orders, and other pertinent documentation.
10. Critically evaluate valid encounters, including face-to-face, legibility and valid signature, per Medicare, Commercial and Federal and State requirements.
11. Assist coding leadership by making recommendations for process improvements to further enhance coding quality goals and outcomes.
12. Understand the anatomy, pathophysiology, and medical terminology necessary to correctly code Facilitate and obtain appropriate physician documentation for any clinical conditions or procedures to support the appropriate severity of illness diagnoses.
13. Performs other duties as assigned.

ORGANIZATIONAL EXPECTATIONS:
1. Creates a positive, professional, service-oriented work environment by supporting the IHA CARES mission and core values statement.
2. Must be able to work effectively as a member of the Compliance team.
3. Successfully completes IHA's "The Customer" training and adheres to IHA's standard of promptly providing a high level of service and respect to internal or external customers.
4. Maintains knowledge of and complies with IHA standards, policies and procedures, including IHA's Employee Handbook.
5. Maintains general knowledge of IHA office services and in the use of all relevant office equipment, computer, and manual systems.
6. Serves as a role model, by demonstrating exceptional ability and willingness to take on new and additional responsibilities. Embraces new ideas and respect cultural differences.
7. Uses resources efficiently.

MEASURED BY: Performance that meets or exceeds IHA CARES Values expectation as outlined in IHA Performance Review document, relative to position.

ESSENTIAL QUALIFICATIONS:
EDUCATION: Bachelor's Degree or equivalent combination of education and experience. CREDENTIALS/LICENSURE: Certified Professional Coder or RHIT certification is required; Certified Risk Adjustment Coder (CRCtm) certification is required.
MINIMUM EXPERIENCE: At least 2 years' experience required abstracting risk adjusted codes from acceptable medical record documentation in either a hospital or physician setting.

POSITION REQUIREMENTS (ABILITIES & SKILLS):
1. Maintain current knowledge of ICD-10-CM codes, CMS documentation requirements, and state and federal regulations.
2. Maintains working knowledge of federal, state, and insurance company regulations and contract requirements affecting compliance in a healthcare setting; compliance plan and auditing standards.
3. Substantial knowledge of managed care and insurance practices, insurance claims and billing process, fee schedules and pricing.
4. Thoroughly comprehend medical coding guidelines and regulations including compliance and reimbursement and the impact of diagnosis coding on risk adjustment payment models.
5. Maintains currency in all coding and reimbursement methods researching literature and attends professional seminars, workshops, and conferences as required by the AHIMA and/or AAPC to maintain professional certification.
6. Maintain and grow the current knowledge of the Medicare and Commercial Risk Adjustment outpatient/inpatient billing systems/processes.
7. Stay current on all changes in coding conventions and coding updates.
8. Adhere to the coding guidelines.
9. Work both in a team and individual environment and is confident working with a wide variety of healthcare professionals.
10. Ability to meet productivity and accuracy standards
11. Ability to defend coding decisions to both internal and external audits.
12. Demonstrated understanding and/or hands-on experience with office processes, procedures and workflows.
13. Proficiency in multi-tasking and meeting sensitive deadlines in a fast-paced environment with a personal commitment to producing the highest quality work and providing extraordinary customer service; demonstrated ability to effectively follow through on assigned projects.
14. Proficient in operating a standard desktop and Windows-based computer system, including but not limited to, Microsoft Word and Excel, intranet and computer navigation. Ability to use other software as required while performing the essential functions of the job including EPM and EHR systems.
15. Excellent communication skills in both written and verbal forms, including proper phone etiquette.
16. Ability to work collaboratively in a team-oriented environment; courteous, professional and friendly demeanor.
17. Ability to work effectively with various levels of organizational members.
18. Good organizational and time management skills to effectively juggle multiple priorities and time constraints in a fast-paced environment.
19. Ability to exercise sound judgment and problem-solving skills.
20. Ability to maintain any organizational information in a confidential manner.
21. Successful completion of IHA competency-based program within introductory and training period. 22. Ability to work overtime hours as scheduled.

07/06/2018

Busy Surgery Center has an immediate opening for an A/R specialist that can post payments, interpret EOB for follow-up, call insurance companies regarding payments and error problems, and help patients that have questions whether they are in the office or calling the billing department. Will work in a team environment that requires collaboration, attention to detail, and a positive outlook. Excellent customer service is required, detailed account experience, able to multi-task each day. At least two years experience in a hospital, clinic, or physician’s office is required. Intermediate Microsoft skills in Word and Excel are required. Send resume and cover letter. Part time (24 hours) Monday through Friday. Variable Hours 6am to 5pm. No Holidays or on-call required.

Submit your resume via email to tbrindley@glbsurgery.com

06/14/2018

GENERAL SUMMARY: Under general supervision performs daily reviews, audits, and corrections to third party claims as necessary to ensure timely payment and reimbursement to HMC. Performs follow up as needed on submitted claims to determine cause of delayed payment and takes all necessary actions to resolve. Acts as a liaison between patients, third party payers, physicians, clinics, departments and the Medical Center in regard to the resolution of any billing related concerns. Participates in quality assessment and continuous quality improvement activities. Complies with all appropriate safety and infection control standards. Performs all job duties and responsibilities in a courteous and customer-focused manner according to the Hurley Family Standards of Behavior.

SUPERVISION RECEIVED: Works under the direction of a departmental director or designee who reviews work for accuracy and conformance to standard procedures.

RESPONSIBILITIES AND DUTIES:

1. Reviews all billings for accuracy and completeness. Checks and verifies all third party identification numbers, diagnoses (ICD9/10), and procedural codes (CPT / HCPCS), modifiers, charges, chart documentation, financial class, insurance proration, etc. using resources such as CCI, LCD/NCD, or other carrier edits. Rebills third party payers and / or patients.

2. Communicates as necessary with patients and / or guarantors via mail, email, and / or telephone to promote timely resolution of third party claims in order to minimize unnecessary customer / patient involvement in the billing / reimbursement process.

3. Contacts appropriate Medical Center departments, physicians, organizations, and eligibility systems to acquire necessary information for patient / insurance billings and reimbursement. Performs appropriate and timely follow up to acquire missing/necessary information to perform billing.

4. Performs daily tasks using prescribed priority / workflows (i.e. daily claims, front-end rejections, denial work queues, follow-up work queues, etc.). Utilizes appropriate systems for both claim processing and follow up activities. Works to maintain a current status of assigned work queues.

5. Documents via system account activities, manual notes, and / or smart text options in order to record the accurate, timely action taken to resolve outstanding balances, denials, and /or other billing issues. Documentation must support account follow-up including, but not limited to financial class changes, transactions, account adjustments, claim corrections, patient interactions, etc.

6. Reviews, investigates, and corrects rejected claims. Reviews account credits and resolves by either submitting refund requests, adjustments, and / or adjustment/replacement claims. Rebills third party payer or patient or notifies management of problem.

7. Acts as liaison among patients, third party payers, and Medical Center with regard to billing issues. May answer telephone inquiries and mail inquiries related to outstanding receivables. Interacts as necessary with internal and external departments to assist in the resolution of billing related inquiries or questions. Interacts as necessary with Financial Customer Service Specialist Team. Escalates billing issues to management timely.

8. Performs updates to patient information including, but not limited to registration, demographic and insurance information as appropriate and necessary. May perform updates and communicate issues with authorizations.

9. Performs necessary clerical tasks to expedite preparation and processing of billings to all applicable third party payers.

10. Under direction of supervisor, performs advanced assignments such as training, and special studies.

11. Performs other related duties as required. Utilizes new improvements and/or technologies that relate to job assignment.

MINIMUM ENTRANCE REQUIREMENTS:

• High school graduate and/or GED equivalent.

• Six (6) months of UB-04 billing experience (e.g., hospital facility billing,) or successful completion of a coding and billing program from an accredited college or university including each of the following: CPT coding, ICD coding, medical terminology, anatomy, and UB-04 billing.

• Working knowledge of inpatient and outpatient billing procedures for third party carriers.

• Knowledge of medical terminology and procedures.

• Ability to use a computer, calculator, and other standard office equipment.

• Ability to communicate effectively both orally and in writing.

• Ability to conform to departmental performance standards.

• Ability to establish and maintain effective working relationships with superiors, co-workers, other Medical Center employees, patients, third party payers, and the general public.

Please send resumes to mcupp1@hurleymc.com

06/14/2018

BHOS-MOS is searching for a Medical Biller with successful experience in collecting old accounts receivable.  Candidates must be very focused on "collecting the money" and have at least 5 years experience in a busy medical office.

The office currently uses Allscripts Pro PM and will be switching to Athena Health in October 2018.  Hours are Monday thru Friday.  Competitive salary and benefits.

Please send resume to mwest@miorthosurgeons.com