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Responsibilities: Manage the collection process for outstanding claims, including contacting insurance companies, patients, and other responsible parties via phone, email, and written correspondence. Communicate as needed with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about .

Overview:
The Revenue Cycle Management Specialist- Collections responsibility is to ensure timely collection of outstanding balances.

Responsibilities:
<ul><li style="margin-left:0.25in">Manage the collection process for outstanding claims, including contacting insurance companies, patients, and other responsible parties via phone, email, and written correspondence. </li><li style="margin-left:0.25in">Investigate and resolve denied or partially paid claims, identifying root causes and implementing corrective actions.</li><li style="margin-left:0.25in">Collaborate with internal teams to address claims challenges and improve revenue cycle. </li><li style="margin-left:0.25in">Escalate complex or uncollectible accounts to management for further action. </li><li style="margin-left:0.25in">Submit appeals/claim corrections as needed within timely filing limits. </li><li style="margin-left:0.25in">Utilize billing software to maintain accurate and detailed records of all collection activities, including communication with payers and patients. </li><li style="margin-left:0.25in">Payer projects as assigned. </li><li style="margin-left:0.25in">Identify and report trends in claim denials and payment challenges. </li><li style="margin-left:0.25in">Communicate as needed with patients about billing issues, including the results of applications for financial hardship assistance and other responses to customer inquiries about </li><li style="margin-left:0.25in">Support accurate and comprehensive record-keeping to ensure up-to-date information is maintained and effectively shared across departments. </li><li style="margin-left:0.25in">Assist in the implementation of processes to measure, assess, and improve the performance of the RCM department activities of the company.</li><li style="margin-left:0.25in">Ensure ongoing compliance with all laws and regulations; ensure that the department meets or exceeds accreditation standards; and implement "best practices" in all departmental </li><li style="margin-left:0.25in">Participate in surveysconducted by authorized inspection </li><li style="margin-left:0.25in">Participate in the company's Performance Improvement program as requested by the Performance Improvement </li><li style="margin-left:0.25in">Participate in company committees when </li><li style="margin-left:0.25in">Participate in in-service education programs provided by the company.</li><li style="margin-left:0.25in">Pursue continuing education programs appropriate to job </li><li style="margin-left:0.25in">Perform other duties as assigned by </li><li style="margin-left:0.25in">Complete all mandatory and regulatory training programs.</li><li style="margin-left:0.25in">Report any misconduct, suspicious or unethical activities to the Compliance </li><li style="margin-left:0.25in">Complies with accepted professional standards and practice.</li></ul>

Qualifications:
Job Skill Requirements:<ul><li style="margin-left:0.25in">Ability to read and interpret medical records for billing purposes. </li><li style="margin-left:0.25in">Competent in mathematic equations. </li><li style="margin-left:0.25in">Ability to compute unit conversions for drugs.</li><li style="margin-left:0.25in">Understanding of CPT, HCPCS, ICD-10, and NDC codes </li><li style="margin-left:0.25in">Diligent attention to detail.</li><li style="margin-left:0.25in">Excellent verbal and written communication. </li><li style="margin-left:0.25in">Understanding of HIPAA compliance. </li><li style="margin-left:0.25in">Self-directed, has the ability to work with little supervision.</li><li style="margin-left:0.25in">Proficiency in Excel, Outlook, and all other office applications.</li><li style="margin-left:0.25in">Familiarity with pharmacy management systems (CPR+, Wellsky, and CareTend, etc.)</li><li style="margin-left:0.25in">Understanding of various insurance plan benefits, payer payment policies, and reimbursement procedures. </li><li style="margin-left:0.25in">Deep understanding of home infusion process, therapies, and related services. </li><li style="margin-left:0.25in">Ability to understand payer explanation of benefits.</li></ul>Educational Requirements:<ul><li style="margin-left:0.25in">High school diploma or GED</li></ul>Experience:<ul><li style="margin-left:0.25in">One to three years of experience in Home Infusion or Specialty Pharmacy collections. </li></ul>

KPH Healthcare Services

Infusion Revenue Cycle Management Specialist - Collections

Accreditation Standards

Best Practices

Billing

Billing Records

Billing Software

CPR Certification

Claims Processing

Corrective Action

Credit and Collections

Current Procedural Terminology (CPT)

Detail Oriented

Finance Software

HIPAA (Health Insurance Portability and Accountability Act)

Healthcare Common Procedure Coding System (HCPCS)

ICD-10

Insurance

Insurance Documentation

Intravenous Therapies

Maintain Compliance

Mathematics

Medical Billing

Medical Records

Microsoft Excel

Microsoft Outlook

Performance Management

Pharmacy

Presentation/Verbal Skills

Process Management

Record Keeping

Regulations

Regulatory Compliance

Reimbursement

Revenue Management

Root Cause Analysis

Software Administration

Time Management

Training Program

Trend Analysis

Writing Skills

[AW]-iCims

Requires a valid Texas Driver's License, appropriate driving record and auto liability insurance that meets the minimum required by State of Texas statute. Some of the other services offered by our well qualified staff include education, intervention, and management of the many social issues that impact our community.

<div>Company Description At Wellness Pointe, everyone will receive an exceptional quality of care. The center has expanded into a multifaceted clinic that offers obstetrics, pediatrics, general medicine, family planning, and dentistry. Some of the other services offered by our well qualified staff include education, intervention, and management of the many social issues that impact our community. Everyone is treated in complete confidence. Medicaid, Medicare, and most private health insurance is accepted. Job Description Our Organization is seeking an energetic, motivated, customer service professional. In this role, the incumbent will register patients by obtaining demographic, insurance, and medical information and collecting co-pays and deposits. Effectively completes a variety of goal-oriented departmental tasks that will require adaptability, attention to detail and efficiency. Essential Duties</div><ul><li>Interviews patients to obtain demographic and insurance information necessary for medical record identification and bill processing.</li><li>Inputs patient registration information into computer system and verifies accuracy of data entered.</li><li>Prepares required forms for signature by patient or family member.</li><li>Requests and collects co-pays and deposits, and issues receipts at time of payment.</li><li>Discusses financial arrangements with incoming patients and/or family members and explains billing and collections policies.</li><li>Communicates with medical/clinical personnel regarding patient access, inter-facility transfers, reimbursement issues, authorization requirements, etc.</li><li>May verify patient insurance coverage and obtain and track authorizations for procedures to be performed.</li><li>Insurance verification</li><li>Pre-authorization of procedures</li></ul> <div>Qualifications</div><ul><li>High School diploma or GED equivalent</li><li>Typically requires one (1) year experience in an office/administrative environment.</li><li>Bilingual ( English and Spanish) required</li><li>Requires a valid Texas Driver's License, appropriate driving record and auto liability insurance that meets the minimum required by State of Texas statute.</li><li>Mental and physical health sufficient to meet the demands of the position.</li><li>Must be able to adhere to all client related policies and procedures including confidentiality.</li><li>Skills Demonstrated human relation and effective communication skills a must</li><li>Experience with EMR software preferred.</li><li>Energetic, forward-thinking and creative individual with high ethical standards and an appropriate professional image.</li><li>The ability to work effectively under pressure.</li><li>Superior organizational and problem solving skills</li></ul> <div>Additional Information Wellness Pointe is an Equal Opportunity Employer.</div>

Wellness Pointe

Patient Support Representative

Academic Intervention

Administrative Skills

Auto Insurance

Co-Payments

Communication Skills

Computer Systems

Customer Support/Service

Data Quality

Demographics

Dentistry

Driver's License

Electronic Medical Records

English Language

Family Medicine

Family Planning

Health Insurance

High School Diploma

Information Technology & Information Systems

Liability Insurance

Medicaid

Medicare

Multilingual

Obstetrics and Gynecology

Organizational Skills

Patient Registration

Pediatrics

Problem Solving Skills

Quality of Care

Spanish Language

Staff Training

State Laws and Regulations

Talent Acquisition

Scheduling patients into applicable medical appointments, such as Psychometric Testing, introduction to Play Therapy, and Play Therapy Appointments. Some of the other services offered by our well qualified staff include education, intervention, and management of the many social issues that impact our community.

Company DescriptionAt Wellness Pointe, everyone will receive an exceptional quality of care. The center has expanded into a multifaceted clinic that offers obstetrics, pediatrics, general medicine, family planning, and dentistry. Some of the other services offered by our well qualified staff include education, intervention, and management of the many social issues that impact our community. Everyone is treated in complete confidence. Medicaid, Medicare, and most private health insurance is accepted. Job Description In this role, the Behavioral Health Assistant will obtain demographic, insurance, and medical information while maintaining patient satisfaction and a good image for the company. Effective completes a variety of goal-oriented departmental tasks that will require adaptability, attention to detail and efficiency.<ul><li style="color:#333333;line-height:normal">Maintain Psychologist schedule and updates as needed to reflect current standing appointments.</li><li style="color:#333333;line-height:normal">Interviews patients to obtain demographic and insurance information necessary for medical record identification and bill processing.</li><li style="color:#333333;line-height:normal">Screens all patient referrals and discusses them with Psychologist to be certain the referral is given the appropriate appointment</li><li style="color:#333333;line-height:normal">Documenting the scheduling of patient and referral calls.</li><li style="color:#333333;line-height:normal">Scheduling patients into applicable medical appointments, such as Psychometric Testing, introduction to Play Therapy, and Play Therapy Appointments</li><li style="color:#333333;line-height:normal">Monthly insurance verification for patients and referrals</li><li style="color:#333333;line-height:normal">Transferring patient calls to appropriate departments.</li><li style="color:#333333;line-height:normal">May create and run miscellaneous reports as directed by the Reservation Center Lead and/or the Patient Support Representative III.</li><li style="color:#333333;line-height:normal">Inputs patient registration information into computer system and verifies accuracy of data entered. </li><li style="color:#333333;line-height:normal">Prepares required forms for signature by patient or family member as needed. </li><li style="color:#333333;line-height:normal">Requests and collects co-pays and deposits, and issues receipts at time of payment as needed. </li><li style="color:#333333;line-height:normal">Discusses financial arrangements with incoming patients and/or family members and explains billing and collections policies. </li><li style="color:#333333;line-height:normal">Communicates with medical/clinical personnel regarding patient access, inter-facility transfers, reimbursement issues, authorization requirements, etc. </li><li style="color:#333333;line-height:normal">May verify patient insurance coverage and obtain and track authorizations for procedures to be performed. </li><li style="color:#333333;line-height:normal">Maintain Inventory of office and play therapy supplies</li><li style="color:#333333;line-height:normal">Carries out other duties as assigned.</li></ul> Qualifications<ul><li style="color:#333333;line-height:normal">High School diploma or GED equivalent.</li><li style="color:#333333;line-height:normal">Minimum six (6) months customer service or office/administration environment experience.</li><li style="color:#333333;line-height:normal">Requires a valid Texas Driver's License, appropriate driving record and auto</li><li style="color:#333333;line-height:normal">liability insurance that meets the minimum required by State of Texas statute.</li><li style="color:#333333;line-height:normal">Mental and physical health sufficient to meet the demands of the position.</li><li style="color:#333333;line-height:normal">Must be able to adhere to all client related policies and procedures including confidentiality.</li><li style="color:#333333;line-height:normal">Pertinent questioning and listening skills that support effective telephone etiquette.</li><li style="color:#333333;line-height:normal">Demonstrated human relation and effective communication skills a must</li><li style="color:#333333;line-height:normal">Experience with EMR software preferred.</li><li style="color:#333333;line-height:normal">Energetic, forward-thinking and creative individual with high ethical standards and an appropriate professional image. </li><li style="color:#333333;line-height:normal">The ability to work effectively under pressure. </li><li style="color:#333333;line-height:normal">Superior organizational and problem solving skills</li><li style="color:#333333;line-height:normal">Bilingual (English and Spanish).</li></ul> Additional information Wellness Pointe is an Equal Opportunity, 'Veteran Friendly' Employer.

Billing Jobs in Longview, TX

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Billing Jobs in Longview, TX

Infusion Revenue Cycle Management Specialist - Collections KPH Healthcare Services

Patient Support Representative Wellness Pointe

Behavioral Health Assistant Wellness Pointe

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