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PMR MK OSS

Company: Covenant HealthCare
Location: Saginaw
Posted on: June 13, 2019

Job Description:

Description



COVENANT HEALTHCARE

US:MI:SAGINAW

DAY SHIFT

FULL TIME BENEFITED



Summary:
The Office Support Specialist is responsible for prompt and accurate clerical, registration and billing practices and follow-up for all hospital and related professional services provided to patients covered by third party payers, including: Medicare, Medicaid, Blue Cross, Commercial, Workers Compensation and all Managed Care Programs. The Specialist is also responsible for securing accurate documentation and processing for timely and accurate reimbursement from third party payers and patients based on appropriate registration/billing and follow up activities. Supports the therapy staff with patient care activities as assigned.

The Office Support Specialist demonstrates excellent customer service performance in that his/her attitude and actions are at all times consistent with the standards contained in the Vision, Mission and Values of Covenant HealthCare and the commitment to Extraordinary Care for Every Generation.



Responsibilities:
Contributes to organization success targets for net operating margin through patient satisfaction and quality outcomes.
Demonstrates excellent customer service. Greets and services patients and family in a courteous, professional manner. Ensures that customer needs are addressed and expectations are met and/or exceeded.
Resolves patient billing inquiries and problems, follows up on outstanding balances due from insurance companies and patients in collaboration with CBO.
Able to assist patient/family with questions or concerns about their account as it pertains to payment/reimbursement and works with CBO in setting up payment contracts.
Has a thorough understanding of all HMO, PPO, and managed care contractual relationships and is able to determine if correct treatments and procedures were provided.
Reviews charges for accuracy of diagnostic/procedure codes and determines the codes necessary to properly reflect services provided.
Provides technical support to therapists by identifying inconsistencies in documentation, diagnosis and/or prescriptions and ensures accuracy for proper reimbursement.
Has a thorough knowledge of scheduling and staffing and makes independent decisions in order to maximize revenue opportunities.
Works with CBO and HIM to ensure proper measures are in place for payment (electronic or hard copy, including initial billing, all insurance re-billing, and secondary or subsequent billings).
Maintains knowledge of federal, state and local billing regulations. Informs management and compliance department of discrepancies.
Analyzes and strictly adheres to all rules/regulations and quickly responds to changes when notified by insurance carriers, employers, third party payers, or government agencies.
Responsible for efficiently, accurately and appropriately maintaining legal medical records for all patients.
Responsible for education of staff with regard to billing accuracy requirements for clean claims, prior authorizations, referrals, certifications/re-certifications, CPT/ICD-9 coding, etc.
Obtains and verifies patient insurance and demographic information and enters necessary updates to system for billing purposes.
Determines, processes, and receives self-pay payments and accurately reconciles daily cash intake.
Facilitates and investigates referral and authorization status for managed care patients.
Ability to handle varying levels of stressful situations under pressure of deadline with frequent interruptions, while remaining professional, responsive and cooperative.
Maintains multiple computer on-line sign-ons and has ability to interpret and glean necessary information from multiple insurance resources/websites.
Understands the Revenue Cycle.
Processes release of information requests consistent with HIPAA and HIM requirements
Answers and responds to multiple phone lines providing appropriate information and/or directs calls to appropriate staff.
Able to prioritize workload effectively. Attention to detail and exceptional organizational skills required.
Proficient in Epic, Cadence and knowledgeable of Enterprise Billing.
Properly maintains legal medical record through accurate point of service scanning and maintenance of paper & electronic records
Supports the therapy staff with patient care activities as assigned (Lokomat monitoring, stand-by assist for transfers/ambulation, etc.)
Works effectively as both a team member and one on one
Ability to communicate effectively both verbally and in writing



Other information:
EDUCATION/EXPERIENCE
Associates Degree in medical field required, or equivalent post-secondary education, preferably in related medical field, with additional knowledge of third party billing, office management, and information technology and/or health information management.
Must have a minimum of 18-24 months of relevant work experience or equivalent combination of training and relevant work experience.
Hospital billing and insurance claim processing experience preferred.
Insurance and/or account follow-up techniques experience preferred.
Physical Medicine & Rehab therapy clinic experience preferred.

KNOWLEDGE/SKILLS/ABILITIES
Should have strong working knowledge of departmental policies, procedures and business operations and be able to analyze and interpret the interrelationship to other departments in the organization
Third party billing and collections
Basic understanding of UB-92, 1500, CPT, ICD-9 Coding.
Knowledge of hospital and/or medical billing and insurance claim filing, insurance and/or account follow-up.
Knowledge of medical and insurance terminology.
Minimal typing skills of 40 words/ minute. Strong computer skills with knowledge in Excel, Word, PowerPoint, e-mail.
Must possess strong clerical skills: 10-key, computer, telephone, copier
Must have strong written and oral communication skills.
Must have ability to work independently or work within a team as well
Protects and maintains the confidential nature of information
Must have excellent organization & time management skills with ability to prioritize workflows
Must be able to function in the OSA role as appropriate

WORKING CONDITIONS/PHYSICAL DEMANDS
Ability to maintain regular, punctual attendance consistent with the ADA, FMLA and other federal, state and local standards.
Constant talking and hearing
Frequent lifting up to 25 lbs.
Frequent standing, walking, sitting, pushing, pulling, twisting, reaching, handling, near vision, midrange vision, far vision, depth perception, visual accommodation, color vision, and field of vision.
Occasional lifting up to 50 lbs.
Occasional lifting, carrying, climbing, balancing, stooping, kneeling, crouching, squatting, and feeling.









NOTICE REGARDING LATEX SENSITIVITY IN APPLICANTS FOR EMPLOYMENT.



IT HAS BEEN DETERMINED THAT COVENANT HEALTHCARE CANNOT PROVIDE A LATEX SAFE OR LATEX FREE WORK ENVIRONMENT AT ANY OF ITS FACILITIES. UNFORTUNATELY, THAT MEANS THAT ANY INDIVIDUAL, INCLUDING AN APPLICANT OR AN EMPLOYEE, IS LIKELY TO BE EXPOSED TO LATEX WHILE ON COVENANT S PREMISES. THEREFORE, LATEX TOLERANCE IS CONSIDERED TO BE AN ESSENTIAL FUNCTION FOR ANY POSITION WITH COVENANT.

Covenant HealthCare is an equal opportunity employer.

Keywords: Covenant HealthCare, Saginaw , PMR MK OSS, Other , Saginaw, Michigan

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