UNKNOWN

FEED

You are responsible for the full accounts receivable life cycle, including analyzing and researching unpaid claims, assisting in the resolution of denials, partial payments, and over-payments as well as communicating with payers, patients and other team members. Identify and resolve denials and improper payments by accessing payer web applications, completing forms and telephoning account representative per New England Cancer Specialists policies.

New England Cancer Specialists (NECS) is currently seeking a full-time Monday- Friday Billing Specialist-Accounts Receivable(AR) to join our professional billing team. As a Billing Specialist-AR, you will perform all collection efforts on assigned Insurance payers. You are responsible for the full accounts receivable life cycle, including analyzing and researching unpaid claims, assisting in the resolution of denials, partial payments, and over-payments as well as communicating with payers, patients and other team members.NECS is a private medical practice composed of 18 oncologists and hematologists serving the state and region from 4 different locations in Maine. NECS is committed to achieving the best outcome and providing unmatched support in all areas for every patient. Nationally recognized as 1 of 12 Oncology Medical Homes in the nation and the first private practice to become a affiliate member of the Dana Farber Cancer Care Collaborative. NECS brings together top clinicians, researchers, and dedicated medical professionals, clinical and non-clinical to create the best possible experience for our patients. Job Duties:<ul><li>Knowledge of New England Cancer Specialists' contractual insurance agreements, insurance denial/appeal processes, and fee schedules.</li><li>Identify and resolve denials and improper payments by accessing payer web applications, completing forms and telephoning account representative per New England Cancer Specialists policies.</li><li>Completes system-generated tasks assigned</li><li>Reviews monthly reports generated to ensure review of underpayments/over-payments variances, credit balances, and fully adjusted charges</li><li>Respond to patient and insurance carrier inquiries on time.</li><li>Monitor accounts receivable status (i.e. aging etc).</li><li>Writes up Refunds per NECS Refund policy</li><li>Familiarize themselves with insurance carrier websites and gets newsletter updates via emails</li><li>Educates Financial advocates, coders and other staff members of changes coming with their assigned carriers via email.</li><li>Establish and maintain relationships with provider representatives</li><li>Works with provider representatives to resolve long-standing issues with carrier, may have to maintain excel spreadsheets of affected accounts</li><li>Attend required meetings and participate in committees as requested.</li><li>Ensure and maintain confidentiality, privacy, and compliance of patient rights per HIPAA regulations and New England Cancer Specialists policies.</li></ul>Monday-Friday work week, no nights or weekendsTravel: Rare Keyword: Medical Billing Specialist-Accounts Receivable Required Experience: <ul><li>High School Diploma or Equivalent</li><li>Minimum of two years medical billing experience</li><li>Certified Professional Coder - Preferred</li><li>Certified Professional Biller - Preferred</li><li>Microsoft Excel Experience - Preferred</li><li>Able to demonstrate full knowledge of insurance payers.</li><li>Must have ICD-10, CPT Coding, and HCPCS knowledge</li><li>Working knowledge of EOB’s, EFT’s, and ERA’s </li><li>Able to demonstrate knowledge of insurance appeal processes.</li><li>Proficient computer skills.</li><li>Must be able to work in a team environment and ability to work independently with minimal supervision</li></ul> Benefits: <ul><li>New England Cancer Specialists offers competitive pay and benefits to our employees. Benefits include medical, prescription, dental, and vision insurances. Short Term and Long Term disability insurances. Tuition reimbursement. Generous Paid Time Off. Company-paid holidays. Paid membership to professional organizations.</li></ul> From: New England Cancer Specialists

Since we opened in 1978, we have focused on one goal, to make the highest quality cancer care accessible to you.
As a private practice with nearly 50% of Maine's medical oncologists and hematologists on our team, we're pleased to introduce a new name that reflects our history of excellence. 

 
 <a href="http://www.mccm.org/" target="_blank" mns_rt="Company" itemprop="url">Click here</a> to learn more about New England Cancer Specialists
 
 <img src="http://media.newjobs.com/mm/xmain_mcfcmx/cjt/MCCM-Imgabt.jpg" alt="Maine Center - Best Place to work" title="Maine Center - Best Place to work"/>

New England Cancer Specialists

Medical Billing Specialist-Accounts Receivable

Accounts Receivable

Billing

Cancer

Certified Professional Coder (CPC)

Computer Skills

Current Procedural Terminology (CPT)

Fee Schedule

HIPAA (Health Insurance Portability and Accountability Act)

Healthcare Common Procedure Coding System (HCPCS)

Hematology

High School Diploma

ICD-10

Insurance

Internet Application

Medical Billing

Medical Research

Microsoft Excel

Newsletter

Oncology

Patient Rights

Regulations

Team Player

Time Management

ATSOndemand

OTHER

Ability to practice autonomously in a remote clinical environment, including independently conducting patient assessments, formulating evidence-based treatment plans, managing complex chronic conditions, and making sound clinical decisions without direct on-site supervision. Pay Range: $2,400.00 - $10,000.00 per month (Potential income) Earnings will vary based on completed assessments, state of residence, and business needs as there is no guarantee of visits or minimum income.

YEAR

Overview:
Nurse Practitioner Per DiemThis position covers all zip codes in:  York County, Maine ComplexCare Solutions (CCS) specializes in helping those in need by delivering high-value home and virtual assessments for health plans nationwide. We pride ourselves on our member engagement aimed towards evaluating current health status, gaps in care, potential health risks and care management opportunities with a focus on driving better clinical outcomes. CCS, on behalf of SME Medical Delaware, P.A., is calling on Advanced Practice Providers that are passionate about helping their local communities. We care dearly about those whom we serve, and we need your help to make a difference in the lives of our members. Providers have the opportunity to spend a full hour with these members, which allows them to capture a comprehensive picture of that individual’s personal needs and what is required to keep them in the home and out of the hospital. Compensation:<ul><li style="margin:0in">Pay Range: $2,400.00 - $10,000.00 per month (Potential income) Earnings will vary based on completed assessments, state of residence, and business needs as there is no guarantee of visits or minimum income</li><li style="margin:0in">In-home visit rate: $120 - $140 depending on state of residence</li><li style="margin:0in">If available, our telehealth rate is $85 per completed assessment</li></ul>Benefit:This position is eligible to participate in a company 401K plan providing the opportunity to save for retirement through employee contributions. New hires will be automatically enrolled in the company 401(k) plan at a 3% contribution rate with the option to opt out.

Responsibilities:
<ul><li>Knowledge of CMS Regulations and NCQA HEDIS Guidelines</li><li>Knowledge of Evidence-based Clinical Practice Standards: American Diabetes Association (ADA), American College of Cardiology (ACC), American Heart Association (AHA), Familiarity with ICD-10 and CPT-4 coding practices</li><li>Complete comprehensive, accurate and thorough review of the assigned member population, including timely completion and submission of all required encounter documentation (paper or electronic)</li><li>Ensure that all pertinent and active medical conditions are documented in the medical record in a manner compliant with CMS/DHHS, Company policy, and client requirements</li><li>Support the physician/patient relationship and ensure timely and adequate communication, documentation of assessment findings, recommendations, need for additional services, emergency services required if necessary and need for follow up and timelines for follow up to primary care provider (PCP) and health plan as required</li><li>Make general recommendations to members intended to improve members' knowledge of their chronic condition(s), such as information concerning recommended testing</li><li>Address and close identified gaps in care (disease-specific or preventive)</li><li>Recognize emergent or urgent situations requiring escalation and take appropriate action as specified in company policies, and as determined by reasonable professional judgment and ethical professional practice standards; and</li><li>Perform, document and communicate results of Point of Care (POC) Testing</li><li>Maintain compliance with Company policies, procedures and mission statement</li><li>Adhere to all confidentiality and HIPAA requirements as outlined within the Company’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position</li><li>Fulfill those responsibilities and/or duties that may be reasonably provided for the purpose of achieving operational and financial success of the Company</li><li>Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function</li><li>On a monthly basis, be available for a minimum of 25 slots of availability per month (approximately 37 hours)</li><li>We reserve the right to change this job description from time to time as business needs dictate and will provide notice of such</li><li>Other duties as assigned</li></ul>

Qualifications:
<ul style="margin-top:0in"><li>Active un-encumbered license to practice nursing</li><li>ANCC or AANP board certification as a Nurse Practitioner or Clinical Nurse Specialist in Family, Adult, Gerontology or Emergency Medicine. </li><li>Maintains current CPR certification</li><li>Compliance, prior to hire, with recommended Healthcare Personnel Requirements for vaccinations and preventive testing:</li><li><ul style="margin-top:0in"><li>Hepatitis B</li><li>Influenza</li><li>MMR: Measles, Mumps and Rubella</li><li>Pertussis, Tetanus and diphtheria and acellular pertussis (Tdap)</li><li>Varicella</li><li>Tuberculosis</li></ul></li><li>Home Health exp a plus </li><li>Must be able to effectively communicate with elderly and chronically ill patients and families</li><li>Understanding of Medicare, Medicaid and Health Plan benefit structures beneficial</li><li>Ability to multitask</li><li>Excellent customer service skills</li><li>Bi-lingual or multi-lingual a plus</li><li>Ability to practice autonomously in a remote clinical environment, including independently conducting patient assessments, formulating evidence-based treatment plans, managing complex chronic conditions, and making sound clinical decisions without direct on-site supervision</li><li>Proficient with computer platforms, electronic health records (EHRs), secure messaging systems, and cloud-based documentation tools</li></ul>This company utilizes E-Verify. ComplexCare Solutions (CCS) is proud to be an equal opportunity workplace and is an affirmative action employer. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status. By embracing diversity, equity and inclusion we enhance our work environment and drive business success. ComplexCare Solutions (CCS) strives to reflect the diversity of the communities where we operate and of our clients and everyone whom we serve. We endeavor to create a culture of inclusion in which our associates feel empowered to bring their full, authentic selves to work and pursue their professional goals in an equitable setting. We understand that by fostering this type of culture, and welcoming different perspectives, we generate innovation and growth.

ComplexCare Solutions

Nurse Practitioner (Per Diem)

American Nurses Credentialing Center (ANCC)

CPR Certification

Cardiology

Centers for Medicare and Medicaid Services (CMS)

Certified Coding Specialist (CCS)

Clinical Nursing

Clinical Outcomes

Clinical Practices/Protocols

Cloud Computing

Communication Skills

Computer Systems

Content Management Systems (CMS)

Corporate Policies

Customer Support/Service

Department of Health and Human Services

Diabetes

Disease

Diversity

Documentation

Emergency Medicine

Emergency Services

Equal Employment Opportunity (EEO)

Health Plan

Healthcare

Healthcare Effectiveness Data and Information Set (HEDIS)

Hepatitis B

Home Care

Hospital

Maintain Compliance

Medicaid

Medical Conditions

Medical Record System

Medical Records

Medicare

Messaging Technology

Multilingual

Multitasking

National Committee for Quality Assurance (NCQA)

Nurse Practitioner

Nursing Credentials

Operations Processes

Patient Assessment

Primary Care

Risk Management

Staff Requirements

Telehealth

Treatment Plan

[AW]-iCims

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Medical Billing Specialist-Accounts ReceivableNew England Cancer Specialists

Nurse Practitioner (Per Diem)ComplexCare Solutions

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