Qureos Mentor

Bayhealth

<div><div>If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
 </div><div>Bayhealth Medical Center is Central and Southern Delaware&rsquo;s healthcare leader with hospitals in Dover and Milford, a s well as stand -alone Emergency Department in Smyrna and a hybrid E mergency Department and Urgent Care in Milton . We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore . Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
</div><div>Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
</div><div><ul><li>Generous Paid Time Off and Paid Holidays
</li><li>Matching 401(k)/403(b) Plans
</li><li>Excellent Health, Dental, and Vision
</li><li>Disability and Life Insurance options
</li><li>On Site Child Care
</li><li>Educational Reimbursement
</li><li>Health Care and Dependent Care Flex Spending Accounts
</li><li>Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
</li></ul></div>Location: 30 Old Rudnick Ln
Status: Full Time 80 Hours
Shift: Days
SALARY RANGE: 19.18 - 28.77HOURLY 
 
General Summary:
The Insurance Follow-Up and Collections Specialist is responsible for following up on all hospital and/or professional insurance claims. The position requires advanced knowledge of all payers and claim types, and the ability to prioritize workflow to meet insurance company filing deadlines for claim submission, claim reconsiderations, and appeals, and achieve targeted receivables monthly, and expedite cash flow. Specific duties involve researching unpaid claims, responding to insurance company information requests, submitting reconsiderations for partially paid claims, interpreting payer denials and reviewing medical records as appropriate, appealing denied claims and resolving payment variances as encountered to facilitate timely patient billing. As needed, the Specialist will make accurate recommendations for system or process changes to mitigate denials. The Specialist also serves as a subject matter expert for colleagues concerning expected reimbursement, denials, and other insurance company contract requirements and/or conflicts. 
 
Responsibilities:
1. Follows up on unpaid claims and appeals via telephone or web-based claim inquiries. Completes imaging system correspondence work queue(s) as appropriate. Identifies and performs appropriate contract and/or other denial related write offs. Research missing payments via undistributed work queues and apply the payment to the correct invoice. Documents accounts thoroughly and appropriately with all information concerning claim and expected payment status and necessary follow up action taken to secure payment.
 
2. Verifies insurance eligibility, corrects claim errors, submits claim reconsiderations, writes appeals, and provides requested information to resolve denied claims. Interacts with various long term care offices to correct denials as appropriate.
 
3. Interprets payer denials, reviews submitted claim information, and medical records to understand the denial. Refers denied claims to correct department work queue with coding recommendations or other clarification questions as needed to resolve the denial; resubmits denied claims with revised information. Refers patients for Financial Assistance based on Medicare/Medicaid benefits exhausted and delayed lower level of care placement scenarios.
 
4. As applicable, converts denied inpatient admissions to observation claims based on the insurance company approving observation.
 
5. Contacts patients to resolve insurance company-initiated information requests as needed to facilitate claim payment.
 
6. Reviews and interprets Federal and State regulations for Medicare and Medicaid and contract terms for Managed Care, Commercial, and Workers Compensation as applicable.
 
7. Understands Bayhealth&rsquo;s contracted reimbursement rates. Reviews insurance company payment variances and, as needed, calculates expected reimbursement for outlier claims and claims with days denied as not medically necessary. Pursues underpaid claims and submits overpayments for refunds. Documents inappropriate denial and payment variances on spreadsheets, participates in calls with insurance company provider representatives, and accurately communicates variance reasons and expected resolution.
 
8. Processes credit balances; submits overpayments electronically to insurance companies who require electronic submission to correct the overpayment. As applicable, reviews the third-party vendor submitted refunds for accuracy.
 
9. Escalates insurance company and internal claim related issues to management as appropriate for resolution.
 
10. Serves as a subject matter expert for colleagues internal and external to PFS. Accurately researches payer issues and provides payer/plan specific education on billing and/or claim requirements. Ensures requests for system and process changes are thoroughly examined before making management recommendations.
 
11. As appropriate, performs Medicare and Medicare Advantage transfer DRG recoveries. Thoroughly researches the Medicare Direct Data Entry system, contacting sub acute facilities and home health agencies as needed to determine revenue recovery opportunities. Submits necessary adjusted claims to recover withheld revenue within payer filing limits. Tracks all claim findings and results in Excel spreadsheet and reports results to management monthly.
 
12. Maintains established department productivity minimums.
 
13. All other duties as assigned within the scope and range of job responsibilities 
 
 
Required Education, Credential(s) and Experience:
<ul><li>Education: High School Diploma or GED
 
;
 
;
 
</li><li>Credential(s): ;
</li><li>Experience: Required: Three years&rsquo; experience in hospital and/or physician billing and collections. 
 
Preferred: Four years hospital billing or collections experience.
</li></ul>Preferred Education, Credential(s) and Experience:
Education: Associate Degree 
<ul><li>
 
 
 
</li>Credential(s): Certified Revenue Cycle Specialist 
<li>
 
 
</li><li>Experience:
</li></ul>To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/</div>

Insurance Follow-Up Specialist

<div><div>If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
 </div><div>Bayhealth Medical Center is Central and Southern Delaware&rsquo;s healthcare leader with hospitals in Dover and Milford, a s well as stand -alone Emergency Department in Smyrna and a hybrid E mergency Department and Urgent Care in Milton . We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore . Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
</div><div>Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
</div><div><ul><li>Generous Paid Time Off and Paid Holidays
</li><li>Matching 401(k)/403(b) Plans
</li><li>Excellent Health, Dental, and Vision
</li><li>Disability and Life Insurance options
</li><li>On Site Child Care
</li><li>Educational Reimbursement
</li><li>Health Care and Dependent Care Flex Spending Accounts
</li><li>Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
</li></ul></div>Location: Kent Campus Hospital
Status: Full Time 72 Hours
Shift: Days
SALARY RANGE: 19.66 - 29.49HOURLY 
 
General Summary:
The ED Unit Secretary greets staff, patients and visitors and helps as needed. They help to maintain compliance with applicable regulatory requirements including, but not limited to CMS, Joint Commission, HIPPA and EMTALA were obtained. Helps to prepare, comply, and maintain patient and operational records in the unit. Performs general secretarial and clerical duties. Coordinates clerical duties of a diverse and confidential nature to maintain efficiency of patient care areas. Place all transfers in the EMTALA Log. Serves as the liaison between physicians and other facilities to coordinate transfers and transportation. Transcribe and communicate physician orders in a timely manner, assuring accuracy and compliance with current policies and procedures. Communicates all alerts to appropriate physicians, surgeons, and other team members. 
 
Responsibilities:
1. Ensure that all consults are placed to the proper group/ physician within in a timely manner, as to not delay patient care.
 
2. Ensure that all alerts and codes (head, heart, stroke, gray, blue and rapids) are placed in proper mechanism or called to operator (Page Gate or perfect serve).
 
3. Notify the trauma surgeon and all appropriate departments for all trauma alerts/ codes, by utilizing the trauma notification check list, ensure that every call is documented with the time the call was placed and with whom you spoke with. If trauma surgeon is in the OR, go down the trauma doctor list until a doctor can be found to come in and cover.
 
4. Initiate transfer calls to other facilities for ED doctors. If patient is to be transferred, ensure that the appropriate imaging (if any) is secured and provided to assigned RN; imaging should also be pushed to the receiving facility. Printing and organizing the chart for transfers that includes an EMTALA, face sheet, and any other pertinent documents.
 
5. Contacting Air Methods for all patients that require flight; if all options are exhausted, look at ground options to secure transport.
 
6. Ensure that all consults are placed to the proper group/ physician within in a timely manner, as to not delay patient care.
 
7. Function as liaison for ED physicians when making calls to other physicians and facilities to attain vital information for patient; ensure that all requested call backs are returned within 15 minutes. If calls are not returned within time frame, facilitate additional call.
 
8. Maintain call log for doctors that include name of doctor contacted, time contacted, time call was returned, and if multiple calls were required.
 
9. Direct all incoming calls from physicians, NP&rsquo;s, and PA&rsquo;s to an ED physician so that report can be given on expected patients.
 
10. Call Real Radiology to get CT &amp; X-ray results per physician request.
 
11. Notify respiratory for all orders placed by physician (breathing treatments, ABG/ VBG, inhaler requests, Bi-Pap, etc.)
 
12. Call materials for replacement crash carts and airway boxes; contact Agility to acquire pumps for the department and notifying plant operations when tube system goes down, call bell system isn&rsquo;t working or when the tv in patients&rsquo; rooms aren&rsquo;t working.
 
13. Coordinate with security to make them aware when there is inmate on site and notify them once patient is moved to floor.
 
14. Contact police when we receive shooting or stabbing victims and follow proper protocol for calling in additional doctors for mass casualties and Medical Examiner and PCP for expired patients.
 
15. Complete deceased log which includes death certificates, transit form, body release form, rhythm strip form, and printing the patient expiration document from Epic.
 
16. Collect paperwork from all pods, registration, swing, and mental wellness unit and place in medical records bin to be collected in morning or place in mail for DMV.
 
17. Confirm that the admission board is complete and up to date, to include that all IMC and ICU patients are updated for billing purposes. This board should also have the consulting physicians, if any, as well as room numbers.
 
18. Complete charging for DME closet using Motion MD.
 
19. Handle multi line phone system; utilize fax machine, call bells, and actively listen to the EMS radio for priority one patients and notify the appropriate departments (trauma doctor, respiratory, anesthesia) while ensuring that all APC/physician/nurses/techs phones are accounted for and fully charged for the beginning of the shift.
 
20. All other duties assigned, within the scope and range of job responsibilities. 
 
 
Required Education, Credential(s) and Experience:
<ul><li>Education: High School Diploma or GED
 
</li><li>Credential(s): Basic Life Support
 
</li><li>Experience:
Required: At least 3 years of medical experience; working in a medical office, registration, scheduling, or front office. At least 2 years of Customer service experience.
</li></ul>Preferred Education, Credential(s) and Experience:
<ul><li>Education: Certificate Program Medical Terminology
 
</li><li>Credential(s): Certified Nursing Assistant
 
</li><li>Experience:
</li></ul>To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/</div>

Emergency Department Unit Secretary

<div><div>If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
 </div><div>Bayhealth Medical Center is Central and Southern Delaware&rsquo;s healthcare leader with hospitals in Dover and Milford, a s well as stand -alone Emergency Department in Smyrna and a hybrid E mergency Department and Urgent Care in Milton . We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore . Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
</div><div>Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
</div><div><ul><li>Generous Paid Time Off and Paid Holidays
</li><li>Matching 401(k)/403(b) Plans
</li><li>Excellent Health, Dental, and Vision
</li><li>Disability and Life Insurance options
</li><li>On Site Child Care
</li><li>Educational Reimbursement
</li><li>Health Care and Dependent Care Flex Spending Accounts
</li><li>Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
</li></ul></div>Location: Kent Campus Hospital
Status: Relief -AS NEEDED
Shift: EVENINGS 3:30PM-MIDNIGHT - WEEKEND AVAILABILITY
SALARY RANGE: 18.73 - 28.09HOURLY 
 
General Summary:
Performs as the onsite call taker for Bayhealth Public Safety, Emergency Line, and Internal Patient Transport. Dispatches and coordinates all on duty Public Safety and Patient Transport team members throughout the organization. Provides alarm monitoring and security surveillance, reviewing and saving surveillance video as directed. During activation of the Emergency Operations Center, acts as command center call taker.
Department team members are authorized to have limited access to secured medication rooms to perform duties and responsibilities as defined in this job description. Any staff member requiring limited access to secured medication rooms must have a fully completed and signed Medication Security Agreement for Non-Licensed Personnel form on file and available upon request. 
 
Responsibilities:
1. Dispatches and coordinates on-duty Public Safety and Patient Transport teams. Promptly responds to and prioritizes telephone requests, assigns staff to perform services such as helicopter arrivals, alarm activations, employee transports/escorts, meal transport, door, and building openings. Make notifications to appropriate hospital staff and assign personnel to locations in the hospital to effectively handle the situation.
 
2. Understand and appropriately utilize security technologies including access control systems, video management systems, incident reporting systems, computer aided dispatching, radio systems, and telephone systems.
 
3. Monitors fire alarm systems, access control, infant abduction systems, and duress alarms for all facilities. Ensure 100% of duress alarms PMs are completed monthly. In addition, monitors alarms specific to facility operations such as boiler pressure low steam, O2 reserves, CHEMPACK storage, medical gases, bone freezer and dispatches appropriate staff or outside agency as necessary.
 
4. Monitors surveillance cameras to ensure the security of the hospital campuses and off-site facilities. Dispatches Security Officers/Constables to investigate any suspicious activity. Controls access to the facilities based on operational procedures.
 
5. Brief the Public Safety Department Director and Manager of any serious (injuries) or incidents where notifications were made.
 
6. Completes employee identification badges, employee vehicle registration, issues appropriate parking decals and enters the information into the automated computer system.
 
7. Collaborates with local and State agencies relative to Medical Center security investigations; directs and/or has agency personnel escorted to hospital buildings and premises
 
8. All other duties as assigned within the scope and range of job responsibilities. 
 
 
Required Education, Credential(s) and Experience:
<ul><li><ul><li>Education: High School Diploma or GED
 
</li><li>Credential(s): Driver License &amp;Driving Record Required.
 
CHSO-Basic within 1 year of hire if not already obtained;
 
Due to insurance carrier requirements, all staff must be at least 21 years of age with a current class D driver&rsquo;s license with no more than 2 moving violations or accidents in the past 3 years.
 
</li><li>Experience: Required: No experience required. 
 
</li></ul></li><li>Preferred Education, Credential(s) and Experience:
</li><li><ul><li>Education: Associate DegreeCriminal Justice
 
</li><li>Credential(s): Basic Life Support
 
Certified Safety &amp; Health Official
 
</li><li>Experience: Preferred: One (1) year experience as a Controller or Dispatcher in criminal justice, law enforcement, or related fields.
</li></ul></li></ul>To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/</div>

Security Operations Center- Dispatcher

<div><div>If you care about the opportunity to grow, to make a difference, to build a future and a life, then we just might have the career for you. Care to talk?
 </div><div>Bayhealth Medical Center is Central and Southern Delaware&rsquo;s healthcare leader with hospitals in Dover and Milford, a s well as stand -alone Emergency Department in Smyrna and a hybrid E mergency Department and Urgent Care in Milton . We offer various practice settings throughout Kent and Sussex Counties. Bayhealth Medical Center Kent Campus is 90 minutes from Philadelphia, Washington, DC and Baltimore . Our Sussex Campus is 30 minutes to the Delaware beaches and relaxation in the sand!
</div><div>Bayhealth Medical Center offers a competitive salary and comprehensive benefits package (for eligible positions) including:
</div><div><ul><li>Generous Paid Time Off and Paid Holidays
</li><li>Matching 401(k)/403(b) Plans
</li><li>Excellent Health, Dental, and Vision
</li><li>Disability and Life Insurance options
</li><li>On Site Child Care
</li><li>Educational Reimbursement
</li><li>Health Care and Dependent Care Flex Spending Accounts
</li><li>Plus, an array of Voluntary Benefits to include Critical Care Coverage and more!
</li></ul></div>Location: Sussex Campus Hospital
Status: Relief - As Needed
Shift: Variable- WEEKEND AVAILABILITY
SALARY RANGE: 18.73 - 28.09HOURLY 
 
General Summary:
Performs as the onsite call taker for Bayhealth Public Safety, Emergency Line, and Internal Patient Transport. Dispatches and coordinates all on duty Public Safety and Patient Transport team members throughout the organization. Provides alarm monitoring and security surveillance, reviewing and saving surveillance video as directed. During activation of the Emergency Operations Center, acts as command center call taker.
Department team members are authorized to have limited access to secured medication rooms to perform duties and responsibilities as defined in this job description. Any staff member requiring limited access to secured medication rooms must have a fully completed and signed Medication Security Agreement for Non-Licensed Personnel form on file and available upon request. 
 
Responsibilities:
1. Dispatches and coordinates on-duty Public Safety and Patient Transport teams. Promptly responds to and prioritizes telephone requests, assigns staff to perform services such as helicopter arrivals, alarm activations, employee transports/escorts, meal transport, door, and building openings. Make notifications to appropriate hospital staff and assign personnel to locations in the hospital to effectively handle the situation.
 
2. Understand and appropriately utilize security technologies including access control systems, video management systems, incident reporting systems, computer aided dispatching, radio systems, and telephone systems.
 
3. Monitors fire alarm systems, access control, infant abduction systems, and duress alarms for all facilities. Ensure 100% of duress alarms PMs are completed monthly. In addition, monitors alarms specific to facility operations such as boiler pressure low steam, O2 reserves, CHEMPACK storage, medical gases, bone freezer and dispatches appropriate staff or outside agency as necessary.
 
4. Monitors surveillance cameras to ensure the security of the hospital campuses and off-site facilities. Dispatches Security Officers/Constables to investigate any suspicious activity. Controls access to the facilities based on operational procedures.
 
5. Brief the Public Safety Department Director and Manager of any serious (injuries) or incidents where notifications were made.
 
6. Completes employee identification badges, employee vehicle registration, issues appropriate parking decals and enters the information into the automated computer system.
 
7. Collaborates with local and State agencies relative to Medical Center security investigations; directs and/or has agency personnel escorted to hospital buildings and premises
 
8. All other duties as assigned within the scope and range of job responsibilities. 
 
 
Required Education, Credential(s) and Experience:
<ul><li>Education: High School Diploma or GED
 
</li><li>Credential(s): Driver License &amp; Driving Record Required.
 
CHSO-Basic within 1 year of hire if not already obtained;
 
Due to insurance carrier requirements, all staff must be at least 21 years of age with a current class D driver&rsquo;s license with no more than 2 moving violations or accidents in the past 3 years.
 
</li><li>Experience: Required: No experience required. 
 
</li></ul>Preferred Education, Credential(s) and Experience:
<ul><li>Education: Associate Degree Criminal Justice
 
</li><li>Credential(s): Basic Life Support
 
Certified Safety &amp; Health Official
 
</li><li>Experience: Preferred: One (1) year experience as a Controller or Dispatcher in criminal justice, law enforcement, or related fields.
</li></ul>To view a full list of all open position at Bayhealth, please visit:
https://apply.bayhealth.org/join/</div>

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Bayhealth

About Company

Insurance Follow-Up Specialist

Emergency Department Unit Secretary

Security Operations Center- Dispatcher

Security Operations Center- Dispatcher