Qureos Mentor

Catalyst Health Group

<div>JOB SUMMARY
The Patient Collections Call Center Sr. will help our communities thrive providing exceptional customer service to our patients helping them
navigate, make payments, and resolve account related issue. We are a culture that is unabashedly driven by purpose. We are making a
difference to our patients and providers while growing at an accelerated rate. 
Every day, we support the health journey of patients by authentically living our core values: Purpose Driven, Relationships Matter, Serve
Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming
organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning
News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox. 
ACCOUNTABILITIES<ul><li>
Uses Technical and Functional Experience</li><li>
Possesses up to date knowledge of the profession and industry</li><li>
Accesses and uses resources when appropriate</li><li>
Demonstrates Adaptability</li><li>
Handles day to day work challenges confidently</li><li>
Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change</li><li>
Shows resilience in the face of constraints, frustrations, or adversity</li><li>
Demonstrates flexibility</li><li>
Customer Service</li><li>
Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients as well as outside contacts so that productivity and positive employee/patient relations are maximized.</li><li>
Uses Sound Judgment</li><li>
Makes timely, cost effective, and sound decisions</li></ul>
ROLE AND RESPONSIBILITIES:<ul><li>
Must possess excellent customer service skills, and demonstrate the ability to support clients, customers, and team members navigate and resolving billing and collection-related issues.</li><li>
Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner. Registers patients in the system as necessary.</li><li>
Collects and reviews all patient insurance information and completes insurance forms. Collects co-pays, deductibles, and other out-of-pocket amounts at the time of visit.</li><li>
Confirms patient insurance verification and eligibility. Obtains pre-authorization of services and/or referrals. Assesses patient financial requirements and advises patients and families on insurance benefits, co-pays, and financial obligations.</li><li>
Posts line items and adjustments to patient accounts. Balances receipts, reconciles daily work batches, and prepares audit trail. Prepares deposits for the bank as needed.</li><li>
Reviews Explanation of Benefits (EOB) for consistency.</li><li>
Submits files and processes all claims for payment. Research and resolve claim delay issues.</li><li>
Resolves patient questions and complaints regarding insurance billing and adjusts accounts as necessary. Resubmits claims and process all insurance/patient correspondence.</li><li>
Provides all documentation to expedite payment.</li><li>
Follows up on assigned accounts. Uses collection techniques to keep accounts current including monitoring for delinquent payments.</li><li>
Sets-up financial arrangements with patients as necessary.</li><li>
As necessary, assists patients with researching and obtaining community resources including housing, transportation, drugs and pharmaceutical supplies, and financial resources.</li><li>
Reviews and resolves patient account discrepancies including but not limited to proper payment application and refunds.</li><li>
Returns critical calls and provides dispute resolutions to customers.</li><li>
Creates training material.</li><li>
Interfaces with patients, providers and other stakeholders.</li><li>
Participates and contributes to organizational projects.</li></ul>
MINIMUM QUALIFICATIONS AND REQUIREMENTS<ul><li>
High School Diploma or equivalent required.</li><li>
Minimum five years of medical business office experience.</li></ul>
PREFERRED EXPERIENCE<ul><li>
Previous medical office experience</li><li>
Previous health related call center experience</li></ul></div>

Sr. Patient Collections Call Center

<div><div>Job Summary
The Medical Billing Coding Specialist Sr. will help our communities thrive by ensuring our practice remains compliant with documentation and coding during claims billing process. We are a culture that is unabashedly driven by purpose. We are making a difference to our patients and providers while growing at an accelerated rate. 
Every day, we support the health journey of patients by authentically living our core values: Purpose Driven, Relationships Matter, Serve Others First, and Inspire Creativity. If you love serving others and would like to make a material difference in an industry-transforming organization, then we invite you to apply to this role. We are recognized as one of the Top 100 Places to Work by The Dallas Morning News, and we have been awarded as one of the fastest-growing privately held companies by SMU Cox. 
Accountabilities<ul><li>
Uses Technical and Functional Experience</li><li>
Possesses up to date knowledge of the profession and industry</li><li>
Accesses and uses resources when appropriate</li><li>
Demonstrates Adaptability</li><li>
Handles day to day work challenges confidently</li><li>
Is willing and able to adjust to multiple demands, shifting priorities, ambiguity, and rapid change</li><li>
Shows resilience in the face of constraints, frustrations, or adversity</li><li>
Demonstrates flexibility</li><li>
Customer Service</li><li>
Demonstrates positive interpersonal relations in dealing with fellow employees, supervisors, physicians, patients as well as outside contacts so that productivity and positive employee/patient relations are maximized.</li><li>
Uses Sound Judgment</li><li>
Makes timely, cost effective, and sound decisions</li></ul>
Role and Responsibilities:<ul><li>
Perform paper and EMR chart audits for all providers in accordance with third party and CMS requirements.</li><li>
Ensure captured charges and billings accurately reflect the medical record according to ICD-10, CPT, HCPCS, and CMS guidelines.</li><li>
Coordinates, schedules, and performs the professional services documentation and coding audits of outpatient records for the practice.</li><li>
Responsible for maintaining up to date knowledge of coding guidelines as they relate to services rendered such as AMA guidelines, Medicare LCD's, commercial payor billing guidelines, coding manuals.</li><li>
Develop and coordinate educational and training programs regarding elements of coding such as appropriate documentation, accurate coding, coding trends found during chart reviews, third party audit findings, and annual coding updates.</li><li>
Recommends procedural improvements and training opportunities to management.
</li><li>Maintains the confidentiality of medical information contained in each record.</li><li>
Assists with other audits such as hospital visits, consultations, and others as assigned.</li><li>
Assists with CHG audit and compliance or reimbursement audits such as providing records, audit reports, and standard operating procedure manuals.</li><li>
Performs Chart Audits</li><li>
Works with healthcare providers to identify areas of coding opportunity to ensure compliance and maximize revenue.
</li><li>Develops training material and leads training.</li><li>
Demonstrate knowledge of state, federal, and third-party claims processing required.</li><li>
Demonstrates knowledge of payer-specific coding requirements.</li><li>
Responsible for coordinating team training on coding and payer related updates.</li><li>
Creates monthly operations performance reports.
</li><li>Reports team performance to Manager and directors on a monthly basis.</li><li>
Contributes to interdepartmental projects to meet business needs.</li><li>
Develops, interfaces and maintains relationships with providers office leadership, including leading monthly KPI meetings as needed.</li><li>
Leads and participates in business unit readouts.</li></ul>
Minimum Qualifications and Requirements:<ul><li>
CPC Certification required.</li><li>
High School diploma with at least five (5) years of billing, coding, and medical records experience required and Minimum two (2) years of insurance resolution experience resolving issues with patients and payers.</li><li>
Must possess a broad knowledge of managed care and HMO policies and procedures and Medicare benefits. Must possess a strong knowledge of current versions of ICD10, CPT and HCPCS.</li><li>
Demonstrate knowledge of medical coding.</li><li>
Proficiency with computer systems and Microsoft Office (Word and Excel) required.</li></ul>
Preferred Experience:
Associate degree in finance, Business</div></div>

Sr Medical Billing Coding Specialist

Join Catalyst Health Group and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Catalyst Health Group

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Sr. Patient Collections Call Center

Sr Medical Billing Coding Specialist