To facilitate accurate Professional Provider credentialing, billing, posting, and collection for ProMedica Physicians and all other supported entities.
ACCOUNTABILITIES
*All duties listed below are essential unless noted otherwise*
1. Accurate and timely credentialing intake for all supported providers with hospital privileges, payor/plan credentialing, certifications, and regulations.
2. Acts as a liaison between providers/office staff and hospitals or payor plans.
3. Accurately maintains provider information in credentialing software.
4. Timely responses to Onboarding providers/plans/hospitals for intake of new providers.
5. Accurately and timely input of billing information into the practice management system for payment.
6. Accurately reviews and updates demographic and insurance information in the practice management system.
7. Perform a variety of registration, billing, follow up and collection functions for all payers including self-pay.
8. Verify insurance benefits, limits, and patient obligations.
9. Contact patients for necessary information pertaining to registration, billing, and collection.
10. Processes electronic remittance advice as well as manual posting files upon receipt from the bank.
11. Reviews and resolves clearinghouse edits and identifies opportunity to build up front edits in the practice management system.
12. Works with clearinghouse on payor registrations and issues.
13. Works with internal departments to obtain information for external requests including refunds.
14. Reviews debits, credits, refunds, bad debt and contractual allowances for accuracy and processes as applicable.
15. Knows and follows all billing regulations and corporate compliance plans.
16. Provide feedback to management on issues that impede timeliness or quality of billing and work with management to resolve.
17. Maintains current payor knowledge for effective claims management and follow up of unresolved claims.
18. Routinely reviews workflows for process improvement and efficiencies and provides feedback to management for implementation of changes.
19. Independently reviews assigned workloads and completion to ensure goals are being met.
20. Perform other duties as assigned.
Location: Remote
Requirements
Education: High school diploma or equivalent.
Skills: Demonstrate the ability to accurately and independently solve problems by passing a basic skills test. Demonstrate excellent communication and interpersonal skills and show a commitment to exceptional customer service. Ability to manage large volumes of work, ability to quickly learn and retain information regarding issues that present themselves. Strong organizational, quantitative, and analytical skills as well as the ability to multi-task. Previous experience with computers and office equipment, as well as be able to input and retrieve information from a computer, operate an adding machine, fax machine and copier. A team player and be supportive of our department and ProMedica mission and values.
Years of Experience: At least 1 years’ experience in Professional/Physician credentialing, registration, billing, customer service or collection with at least 6 months’ experience specific to credentialing and/or billing office work. If applicable to position must have the following:
- Experience reading hospital/Physician medical records
- Detailed understanding of CPT & ICD-9 (10) coding
- Detailed understanding of Professional charging processes
- Detailed understanding and ability to interpret payor EOB
- Experience completing hospital and payor credentialing forms
Pay Range: $31,200-$47,320
We offer a competitive benefits package with coverage effective day one of employment which includes medical, dental, vision, company paid life insurance, paid time off, a 401k retirement plan, an employee assistance program and other voluntary coverage options and employee discounts.
The above list of accountabilities is intended to describe the general nature and level of work performed by the incumbent; it should not be considered exhaustive.
ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica
Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org
Equal Opportunity Employer/Drug-Free Workplace
