PMR MK OSS
Company: Covenant HealthCare
Posted on: June 13, 2019
FULL TIME BENEFITED
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
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.
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
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
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
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
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
Understands the Revenue Cycle.
Processes release of information requests consistent with HIPAA and
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
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,
Works effectively as both a team member and one on one
Ability to communicate effectively both verbally and in writing
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
Hospital billing and insurance claim processing experience
Insurance and/or account follow-up techniques experience
Physical Medicine & Rehab therapy clinic experience preferred.
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
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,
Must have strong written and oral communication skills.
Must have ability to work independently or work within a team as
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
Occasional lifting up to 50 lbs.
Occasional lifting, carrying, climbing, balancing, stooping,
kneeling, crouching, squatting, and feeling.
NOTICE REGARDING LATEX SENSITIVITY IN APPLICANTS FOR
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
Didn't find what you're looking for? Search again!