11/15/2022

Due to exciting growth we are seeking a Professional Billing Services Manager to join our Revenue Cycle Team!

To apply please send resume to cindy.collins@cmich.edu, or apply online at: https://careers-cmich.icims.com/jobs/1527/professional-billing-services-manager/job

Overview: The Professional Billing Services Manager is responsible for oversight of day-to-day tasks assigned to medical billing staff within the revenue cycle department. The Professional Billing Services Managers responsibilities include identifying insurance reimbursement issues, ensuring claims, denials, and appeals are efficiently processed, and organizational metrics are achieved. Essential Functions: • Under direction of the Revenue Cycle Director, Manager will be responsible for oversight of day-to-day departmental activities, monitoring aging and denial work queues to ensure organization metrics related to aging and collections targets are met and taking first line questions and monitoring established daily activity and productivity metrics. • Achieve and maintain reimbursement related key performance indicators and benchmarking revenue cycle goals (i.e., reducing days in A/R, decreasing outstanding receivables, increasing first pass rate %). • In collaboration with Revenue Cycle Director, and clinical program managers, implement processes to ensure services provided in both ambulatory and inpatient settings are accurately captured and billed timely according to organizational expectations. • Implement agreed upon departmental workflows and monitor compliance to ensure identified metrics are met. When metrics are not met, identify issues impacting success, develop and implement plans to address, and escalate to the Revenue Cycle Director in accordance with organizational expectations. • Work in conjunction with Professional Billing Services Coordinator and Lead Coder on process improvement goals related to reducing claim denials. • Understands and supports quality related performance incentive programs offered by health plans and coordinate with clinical teams, quality representatives, operations, PCMH representatives, coding, and billing personnel to ensure measures are properly recorded and submitted. • Monitor staff performance based on expectations set by Revenue Cycle Director and provide regular feedback of overall team and individual expectations with employee and Revenue Cycle Director. • Counsel, develop and evaluate the performance of direct reports to organizational standards, expected behaviors, corporate values, and policies. • Maintain personal and professional growth and expertise by remaining current with state and federal associations and with professional trends, and by participating in payer sponsored educational events.

Education and Experience: • Associate degree or three to five years of relevant experience (physician billing, coding, or provider credentialing experience); Bachelor’s degree preferred • Three years of relevant physician billing, coding acting in a lead or supervisory capacity • Preferred experience working in EPIC or equivalent EMR. • Must possess strong leadership, organizational and planning skills. • Demonstrated ability to manage complex tasks effectively, including exceptional attention to detail, organization, timeliness, and follow-through.

11/08/2022

Medical Billing Position: Full or Part Time A successful candidate for this position will have the experience and knowledge to accurately post insurance and patient payments, resolve denied claims, work the patient and insurance accounts receivables in a timely manner.

Core Job Requirements: Must be a highly organized person with the ability to work independently. Have a positive attitude and be polite in all verbal and written correspondences, including phone calls with patients and insurance companies. Accurately post and balance all insurance and patient payments. Work the insurance and patient accounts receivable-denial management of unpaid medical claims. Resubmit insurance claims as necessary with all supporting documentation, including appeals. Process insurance take-backs or prepare refund forms for all accounts identified as an over paid. Have a working knowledge of CPT and ICD-10 codes, CCI edits, HIPAA and government regulations. Performs other duties or functions as assigned.

Required Qualifications: A minimum of three (3) years working experience as a Medical Biller with Accounts Receivable Experience. Prefer individual with proficiency in Allscripts Practice Management software and Microsoft Office.

Please send resume to Dr. Ramirez by email, rose.ramirez@jupiterfamilymed.com

10/28/2022

The role of the administrative assistant is a remote position (15-20 hrs/week)

This position is as contract services administrative support  (1099 self-employed position)

• Responsible for the day to day running of the MMBA office
• Assist members with the website (help with login, membership renewal and meeting registrations)
• Send out meeting notices and reminders  
• Manage RSVP through mail, website and communicate to chapters with the final sign in  
• Maintain database and develop list according to preference, clear bounce backs and unsubscribed from contact lists weekly
• Assist Chapter Co-Chairs with meeting details, set up GoToWebinar meeting, add event to website
• Help create forms available to all board members in a shared location
• Work with VP of Communications on social networking, website , email blasts
• Sending out annual membership renewals (Email and/or postcards)
• Developing non-member mailing lists (MSMS and AMBA)
• Answering phones and emails
• Send CEU certificates to members that have completed On-Demand sessions after review of GTM Video Log
• Maintain inventory of MMBA supplies, make sure each chapter has marketing items
• Copying, printing as requested by board members
• Attend local in –person chapter meetings
• Prepare necessary packets for Semi-Annual and Annual Board meetings including agenda, financial reports and chapter reports
• The AA will take the lead on any questions, emails generated by the website (Contact Us and forum posts)

Please forward resume and letter of introduction to info@mmbaonline.org

10/12/2022

Alliance Healthcare Solutions in Grand Rapids, MI Medical Billing Specialist Remote Position: Full or Part Time

A successful candidate for this position will have the experience and knowledge to accurately post insurance and patient payments, resolve denied claims, work the patient and insurance accounts receivables in a timely manner. Core Job Requirements: Must be a highly organized person with the ability to work independently. Have a positive attitude and be polite in all verbal and written correspondences, including phone calls with patients and insurance companies. Accurately post and balance all insurance and patient payments. Work the insurance and patient accounts receivable-denial management of unpaid medical claims. Resubmit insurance claims as necessary with all supporting documentation, including appeals. Process insurance take-backs or prepare refund forms for all accounts identified as an over paid. Place unpaid patient balances with external collection agency. Have a working knowledge of CPT and ICD-10 codes, CCI edits, HIPAA and government regulations. Provide PTO coverage for other staff members. Performs other duties or functions as assigned.

Required Qualifications: A minimum of three (3) years working experience as a Medical Biller with Accounts Receivable Experience. Proficient with medical practice software systems and Microsoft Office.

Please send cover letter and resume to: lori@alliancehealthcare-solutions.com

09/20/2022

Seeking full time Medical Biller for busy two location ophthalmology practice and onsite surgery center. Should have excellent communication skills for working with patients. Should have three years experience or be a recent graduate from a billing education program. Excellent, flexible hours and benefits. Please send resume to nbarlog@millman-derr.com

08/10/2022

POSITION SUMMARY Responsible for patient customer service, insurance and patient payment posting, account receivable review, resolution of unpaid and denial claims from insurance carriers, patient account collection including pre-collect and working with outside collection vendors. ESSENTIAL

RESPONSIBILITIES • Assist incoming calls to the billing department in a prompt and courteous manner; researching account balances for payment resolution. • Verify patient insurance coverage for your payer. • Accurately add payer information into patient chart. • Post all payments by line item in a timely and accurate manner. Balance transactions at the completion of each batch. • Identify all payments and rejections that weren't processed correctly or according to contract for further department action. • Accurately and timely, create a secondary claim in NextGen and forward the explanation of benefits to insurance claims processing staff. • Print and forward all EOB's to appropriate insurance collector identified as not paid per contract or require additional information and research. • Process refund forms for all accounts identified during posting as overpaid. • Work with insurance companies to identify payments that were received without explanation of benefits or not identifiable. • Identify, track, and resolve overdue insurance balances using NextGen tasking system. • Communicate with payers to appeal payments that do not match contractual agreements. • Prepare and submit professional appeal letters to insurance payers on claims rejected or paid incorrectly. • Resubmit insurance claims as necessary with all supporting documentation. • Respond to written and telephone inquiries from insurance carriers. • Manage relationships with staff from assigned insurance carriers. • Process refund request form for all accounts identified as overpaid. • Provide support on patient account calls in a prompt and courteous manner. Research accounts balances and correct errors as necessary. • Meet with Manager regularly to discuss reimbursement and insurance follow up problems, patient account status • Maintain patient confidentiality; comply with HIPAA and compliance guidelines established by the practice. • Performs other duties or functions as assigned.

REQUIRED/DESIRED QUALIFICATIONS Education, Training and Experience: § High school diploma § Three years of medical billing experience required Specific skills, knowledge and abilities: § Proven success in receivables follow-up and denials management § Proven success in payment posting and balancing a cash drawer § Working knowledge of medical billing and managed care § Strong verbal communication skills § Highly organized, detail oriented, and self-motivated § Microsoft Office and Windows based computer applications Remote Requirements • Employee provides clearly defined safe workspace including (but not limited to) desk, chair, surge protector and high speed internet. • Employee agrees that OAM equipment will not be used by anyone other than the employee and only for business related work. The employee will not make any changes to security or administrative settings on OAM equipment. The employee understands that all tools and resources provided by the company shall remain the property of the company at all times. • The employee will report any internet or power outages to his or her supervisor and make appropriate temporary work arrangements for completing work duties. •

Employee will review further remote requirements in the Telecommunting Agreement and sign prior to acceptance of employment. Motor, sensory and physical requirements: • Ability to sit for prolonged periods of time • Frequent bending, stooping, lifting and reaching required • Employee may be required to lift up to 30 pounds. • Manual dexterity required to operate modern office equipment • Employee must have normal or correctible range of hearing and eyesight.

Please email resume to:  daniel.lewis@oamichigan.com

07/07/2022

The Senior Director of Revenue Cycle provides managerial direction, leadership, consultation and expertise for the revenue cycle management team. Responsible for identifying opportunities for enhancement and/or standardization initiatives, managing the long-term success and sustainability of those initiatives, and continuous improvement projects OAM.

Work assignments require significant management and/or consulting knowledge and experience in order to plan, coordinate, influence and control the activities of others, as well as integrate activities that are relatively homogenous or diverse in nature. Motivates team to achieve the highest levels of customer satisfaction and to meet the organization goals for customer service, operational and financial performance in order to achieve a highly functioning revenue cycle team.

Our ideal candidate would have the following qualifications: -Bachelors degree in business or related field preferred -Comprehensive knowledge of revenue cycle functions and systems -Strong knowledge of physician practice management systems. NextGen experience is preferred. -Ten or more years of experience in healthcare within the area of revenue cycle specifically managing performance improvement or continuous process improvement projects other management functions related to revenue cycle activities. Professional and ancillary related services experience is preferred. -Experience in private practice preferred.

Please send resume to the attention of: lisa.idema@oamichigan.com

04/22/2022

General Summary: Under limited direction, the Patient Financial Experiences Rep is responsible to assist patients in resolution of Hospital and Professional billing and insurance concerns. In addition, Patient Financial Experiences Rep will aid patients in enrolling in Financial Assistance or supplemental payment plans such as Care Payment; provide charge estimates, and collect payments. Goal is to provide exceptional customer service to all callers while ensuring prompt, accurate reimbursement for services rendered.

Requirements: Minimum high school diploma or GED required. Two (2) years of experience working in an accredited hospital, physician office or medical call center. Background in facility and professional claims resolution preferred. Knowledge of medical terminology, ICD-10, CPT codes preferred. EPIC or Revenue Cycle Certification a plus. Ability to work independently with minimal supervision. Excellent oral and written communication skills. Proficiency with computer functions, including ability to use automated systems for third party billing and insurance follow up. Professional, business-like appearance and demeanor. Recognizes and reports problems, errors and discrepancies to management. Shares information with co-workers. Ability to contribute to team efforts.

Essential Functions and Responsibilities: Provides exceptional customer service to all patients/callers by offering assistance and ensuring customer satisfaction. Answers inbound customer calls for at least 80% of the workday responding to inquiries with empathy and personal integrity. Handles challenging patients and customers effectively and professionally. Interpret insurance plan benefits and explain patient’s financial liability for deductible, co-insurance, and/or non-covered benefits. Provides charge and out-of-pocket estimates for medical services/procedures. Works closely with Hospital and/or Physician office staff to obtain correct information for billing purposes. Posts cash payments and reconcile vouchers according to department standard work plan. Review and interpret insurance plan benefits, explanation of benefits forms and validate the payments and adjustments made on accounts are correct. Maintains daily work queues according to payer requirements, including credit balances. Assists patients with enrollment in payment plans, Patient Financial Assistance and/or Care Payment. Responsible for quality and productivity standards established by management. Complete knowledge of payer guidelines, including utilization of payer websites and other tools. Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating on committees, task forces, and work groups as determined by management.

Please apply here:  https://metrohealth.csod.com/ats/careersite/JobDetails.aspx?id=4327&site=2 

04/04/2022

03/14/2022

Orthopaedic Associates of Michigan is looking to add a Coding Specialist to our team! This is a remote position, but candidates must live in the state of Michigan.

Job Summary: In an accurate and timely manner, assigns CPT and ICD10 codes to procedures based on the physician or mid-level provider's documentation and enters those charges in the practice management system.

This position will also be working on coding denials and tasks, writing appeal letters, and assist with coding consults. Interested applicants can apply on our career page: www.oamichigan.com/careers

03/10/2022

DIFS is hiring THREE highly organized individuals with exceptional written and verbal communication skills to handle complex health care provider appeals and applications for certification in the Utilization Review Unit within the Office of Research, Rules, and Appeals.

The successful applicant will work in an area that is vital to the new auto insurance reform law. The work will involving reviewing and analyzing complex documentation and ensuring that equitable treatment and consideration is given to the health care provider and insurance company under the law and rules.

Applicants can apply and read more about the position, at the following link: https://www.governmentjobs.com/careers/michigan/jobs/3458681/departmental-analyst?department[0]=Department%20of%20Insurance%20and%20Financial%20Services&sort=PositionTitle%7CAscending&pagetype=jobOpportunitiesJobs

02/21/2022

02/08/2022

01/07/2022

12/13/2021

Overview – Provider Relations Specialist

Pay Range: R10

FLSA Status: Non-Exempt

Union Status: Represented

Job Code: B14A05

 SUMMARY: 

Responsible for addressing complex and high-priority bill inquiries from providers, agents, and clients. Responsible for providing quality, consistent and accurate payment information to internal and external customers. Also responsible for analyzing billings including outpatient hospital and multiple surgeries by utilizing our Medical Bill Review (MBR) software and reference library to determine the appropriateness of codes and excessive charges. Responsible for making coding determinations according to state rules and regulations.

WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards. 

REQUIRED TESTING:

Proofreading, 10 Key, Math, Basic Windows, Reading Comprehension, Alpha Numeric

Responsibilities

• Responsible for performing technical review of more complex medical bills, including but not limited to modifiers, anesthesia, & psychiatric. 
• Responsible for generating assigned medical bills to determine compliance with business rules, client-specific requirements, and state-specific fee schedules, rules, regulations, and guidelines.
• Responsible for analyzing complex billings for multi-state Workers' Compensation medical claims to determine appropriateness of services billed. 
• Responsible for making bill review processing determination according to rules and regulations and or third party partner.
• Evaluates medical bills and corresponding EOR’s for accuracy and compliance with state-mandated fee schedule(s) and our business rules and guidelines.
• Reviews inpatient hospital, outpatient hospital, and multiple surgery billings.
• Reviews, analyzes, adjusts, and releases queued bills in an accurate and timely manner.
• Refers to reference library of fee schedules, CPT, ICD-9 (10), HCPCS, and other industry publications to support findings.
• Process reconsiderations, as needed.
• Identifies system and/or bill review processing issues and reports findings to Supervisor or Manager.
• Provides high level of customer service for all business partners, internal or external customers thru telephonic, email, and fax.
• Demonstrates a dependable work ethic.
• Manages confidential client information with discretion and good judgment in accordance with department and company guidelines.
• Collaborates with supervisor to develop skills and knowledge.
• Identifies problems, provides solutions, and resolves promptly; escalating more complex problems appropriately.
• Responds to written or verbal provider inquiries relating to our bill review analysis. Analyzes problems using problem-solving methodology skills to determine root cause; communicates and implements solutions.
• Acts as a resource to MBR employees in regard to bill review questions and concerns.

REQUIREMENTS

EDUCATION REQUIRED:

• High School Diploma or G.E.D. Additional training or course work in a medical field required.

OR

• Degree or Certification in Medical Coding

EXPERIENCE REQUIRED:

• One year as a Medical Bill Review Specialist II

OR

• Three years experience in an insurance organization with two years demonstrated technical knowledge in medical bill review or other relevant experience, which provides necessary skills, knowledge, and abilities. One year experience in Workers' Compensation industry required. Previous experience in customer service required.

OR

• Degree or certification in medical coding with one to two years customer service experience in a medical setting.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Ability to use independent discretion to make choices on proper reimbursement.
• Basic knowledge of computers.
• Working knowledge, experience, and ability to process bills using state medical payment methodologies.  
• Ability to proofread documents for accuracy of spelling, grammar, punctuation, and format.
• Ability to perform mathematical calculations with the ability to use a ten-key pad with accuracy.
• Ability to manage work with minimal direction.
• Excellent oral, written communication, and customer service skills.
• Thorough knowledge of Workers' Compensation multi-state medical fee schedules, Medical guidelines, medical terminology, and CPT/ICD-9/10.
• Demonstrated attention to detail.
• Basic knowledge of the Workers' Compensation Act.
• Ability to consistently meet or exceed daily production and quality standard for this position.

ADDITIONAL EDUCATION, EXPERIENCE, SKILLS, KNOWLEDGE, AND/OR ABILITIES PREFERRED: 

• One year of previous telephonic experience.
• Degree in medical coding.
• Basic knowledge of Claims process including medical reserving procedure.

If interested, please apply online at:  https://www.accidentfund.com

12/06/2021

Billing Specialist Our busy medical office is looking for a full time, skilled billing specialist/medical biller to join our team. Our office provides emergency services in the greater Grand Rapids area.

Benefits begin immediately upon start date! Hourly wage begins at $19.00 per hour.

Benefits include Health and dental insurance, contribution to HSA account, 401(K) profit sharing, paid time off. No holidays or weekends!

Responsibilities for the billing specialist/medical biller include: • Answering phones • Charge entry • Medicare and BCBS billing • Medical appeals • Collections Requirements for the medical biller/billing specialist include: • Great customer service and phone etiquette • Strong data entry skills • Detail oriented • Knowledge of Microsoft Excel • 2 years of general or medical office experience preferred Those with previous Medicare billing and appeals processing experience are highly encouraged to apply.

Please send resume attention: CTW to info@grandmg.com or fax to 616-235-1212