patient account representative

MedMark Treatment Centers

<div><div>Full Time - Patient Access Representative / Patient Account Representative
</div><div>MedMark Treatment Center is looking for hard-working and conscientious Patient Access Representative / Patient Account Representative to perform various administrative tasks with a keen eye for detail. The patient account representative is primarily responsible for patient billing, including verification of invoice information, maintenance of third party billing records, and resolution of a variety of problems.</div><div></div><div> 
Responsibilities:
</div><ul><li>Review, maintain, and process fiscal/account records and transactions related to patient&rsquo;s accounts.</li><li>
Verify insurance benefits and billing information by terminal and/or telephone. Annotate accounts with insurance coverage and estimated patient shares.</li><li>
Contact third party payers (insurance providers and state/federal agencies) for payment post billing.</li><li>
Resolve issues with payment and billing, authorization process.</li><li>
Reconcile daily money collected.</li><li>
Forward information as appropriate to expedite payment.</li><li>
Maintain accurate accounts, i.e. required signatures, proper account annotation, current demographics, and correspondence.</li><li>
Insure completion of pre-authorization process by inquiry and referral to clinician.</li><li>
Monitor insurance authorizations and claim rejections.</li><li>
Maintains fiscal records and/or worksheets for all calculations, extensions, and verifications related to record keeping for assigned patient&rsquo;s accounts.</li><li>
Perform tasks consistent with authorization and billing requirements.</li><li>
Contact patients for payment of account or payment arrangements according to current policy.</li><li>
Manage revenue cycle, production logs, balances and collections for self-pay clients.</li><li>
Maintain confidentiality of patient records.</li><li>
Assists with archiving discharged files, including archiving</li><li>
Respond appropriately to requests for information regarding accounts from payer, attorney, and others.</li><li>
Backup Receptionist as needed by: Checking in patients, collecting payments, answering phones, scheduling intakes, and data entry.</li><li>
Other duties, as assigned.</li></ul><div>
Qualifications:</div><ul><li>
High school diploma or equivalent with at least 2 years&rsquo; prior experience in a medical office setting.
</li><li>2-4 years&rsquo; experience with Medicaid and PAC and commercial insurance (preferred)</li><li>
Excellent customer service skills and professional public presentation skills, including telephone etiquette.</li><li>
Knowledge of medical insurance claims procedures, documentation and records maintenance.
</li><li>Knowledge of medical billing procedures, gather and compile data into reports.</li><li>
Proficient in basic PC skills. Microsoft Word and Excel preferred.</li><li>
Ability to communicate effectively, both orally and in writing.</li><li>
Self-directed with the ability to work with little supervision.</li><li>
Ability to understand and follow oral and written directions, establish and maintain effective working relationships with patients, program management, medical staff, counselors and peers.</li><li>
Ability to work with a diverse population, manage stressful situations and exhibit excellent customer service skills.</li><li>
Satisfactory drug screen and criminal background check.
</li></ul><div>Salary Range:
</div>Salary ranges from $16.36 to $17.36 an hour.
The salary of the candidate(s) selected for this role will be set based on a variety of factors, including but not limited to, experience, education, specialty and training.<div>
BayMark offers excellent benefits:
</div><ul><li>401K match</li><li>
Medical, Dental, Vision Insurance</li><li>
Accident Injury, Hospital Indemnity and Critical Illness Plans
</li><li>Company paid Short &amp; Long Term Disability</li><li>
Company paid Basic Life Insurance</li><li>
Paid Time Off</li><li>
Bereavement Leave</li><li>
Flexible Sick Time</li><li>
Employee Referral Program</li></ul><div>
Total compensation goes beyond the value on the paycheck. Please consider the total compensation package by contacting us at BayMark Health Services for more information.</div><div></div><div> 
Here is what you can expect from us:</div><div>
MedMark Treatment Center a progressive substance abuse treatment organization, is committed to the highest quality of patient care in a comfortable outpatient clinic setting. Our ultimate goal is to address the physical, emotional, and mental aspects of opioid use disorder to help each of our patients achieve long-term recovery and an improved quality of life.</div><div> 
</div><div>MedMark Treatment Center is committed to Equal Employment Opportunity (EEO) and to compliance with all Federal, State and local laws that prohibit employment discrimination on the basis of race, color, age, natural origin, ethnicity, religion, gender, pregnancy, marital status, sexual orientation, citizenship, genetic disposition, disability or veteran&rsquo;s status or any other classification protected by State/Federal laws.</div></div><div></div>

Patient Access Representative

Northwest Pathology, PS

<div><div>JOB SUMMARY
This position executes and supports all client billing functions and tasks. The Client Account Service Representative also ensures and performs a variety of clerical and registration functions for patient billing, including verification of patient demographics, insurance billing information and maintenance of the billing record.
Avero Diagnostics operates on a 24/7/365 basis; individuals may be required to work various shifts, including days, nights, weekends, and holidays. It is required to have schedule flexibility with and without advanced notice.
 ESSENTIAL JOB DUTIES<ul><li>
Efficiently and accurately enters all insurance payers into the Practice Management systems in a timely manner.</li><li>
Maintains patient demographic information and data collection systems.</li><li>
Adheres to quality assurance, metrics, safety and other departmental and company procedures and record privacy protocols.</li><li>
Ensure all existing and new hire Client Account Service Representatives are welcomed with peer training on all systems.</li><li>
Research and respond by telephone and in writing to patients, clinic or insurance inquiries regarding billing issues and problems.</li><li>
Patient collections include payment plans for delinquent accounts.</li><li>
Attend various training sessions and meetings as needed.</li><li>
Performs other related tasks as directed/assigned.</li></ul>
EDUCATION/CERTIFICATION/LICENSE<ul><li>
High School Diploma or equivalent required; college degree is a plus</li><li>
Active and valid US State-Issued Driver&rsquo;s License with acceptable motor vehicle record as defined and approved by the company&rsquo;s vehicle insurance carrier.</li></ul>
EXPERIENCE<ul><li>
Minimum 1 year of experience required:</li><li>
High demand, fast paced, exceptional patient/customer service environment.</li><li>
Proficiency with computers and strong, accurate typing skills</li><li>
Insurance EOBS</li><li>
Laboratory and/or healthcare environment experience is a plus.</li></ul>
KNOWLEDGE, SKILLS AND ABILITIES<ul><li>
Solid understanding of medical billing.</li><li>
Exhibits patience and approachability, sets positive tone and example for team member behavior, work ethic &amp; quality, abilities, skills and overall performance.</li><li>
Maintains confidentiality at all levels and consistently acts with high integrity.</li><li>
Demonstrates patience, and approachability, and sets a positive tone for team behavior, work ethic, quality, and overall performance, focusing on team success over individual achievement.</li><li>
Consistently delivers high-quality work on time and takes responsibility for outcomes.</li><li>
Build and sustain effective relationships with team members across all organizational levels.</li><li>
Exhibits professional communication abilities, including listening, writing, and speaking fluently and effectively in English.</li><li>
Works effectively both collaboratively within a team and independently with minimal supervision.</li><li>
Thrives in fast-paced, high-growth environments, managing competing priorities and frequent interruptions with ease.</li><li>
Functions as a responsible, organized initiative-taker with excellent time management, follow-through, and a commitment to continuous learning and improvement.</li><li>
Possesses strong analytical and research skills with an initiative-taking approach to identifying, assessing, and resolving complex challenges and processes.</li><li>
Demonstrates effective facilitation, negotiation, and conflict resolution skills.</li><li>
Skilled in utilizing various software applications, including MS Windows, Outlook, Word, Excel, and healthcare databases/systems.</li><li>
Maintains regular, reliable attendance and punctuality.</li><li>
Maintains a professional appearance, communication style, and demeanor.</li></ul>
WORKING CONDITIONS<ul><li>
This position operates in a remote only capacity but in partnership with a fast-paced office and lab environment, requiring adherence to daily workload demands.</li><li>
The role involves regular use of standard office equipment, including computers, printers, phones, and mobile devices, in a work environment with noise levels ranging from moderate to loud.</li></ul>
PHYSICAL REQUIREMENTS<ul><li>
The position may require exerting up to 20 pounds of force occasionally, 10 pounds frequently, and negligible force constantly to move objects.</li><li>
Regular activities include talking, hearing, sitting, standing, walking, using hands to manage or feel, grasping, reaching, and performing repetitive movements with wrists, hands, and fingers.</li><li>
Specific vision abilities include close visual acuity and the ability to adjust focus for tasks such as data analysis, reading reports, transcribing, viewing computer monitors, and legally operating a motor vehicle.</li><li>
Avero is an equal-opportunity employer and strives to provide a workplace free of discrimination and harassment. We are committed to providing reasonable accommodation to qualified individuals with disabilities in accordance with applicable laws.</li></ul>
The duties and responsibilities outlined in this job description are intended to provide a general overview of the primary functions, required knowledge and skills, and scope of responsibility for the role. This is not an exhaustive list of all job requirements, and employees may be asked to perform additional duties, work various shifts, or assist in other areas to cover absences, manage peak workloads, or balance staffing needs. These job details are not intended to create an employment contract and are subject to change at the employer's discretion.</div> 
Tuesday through Thursday 8:00 AM to 2:00 PM</div>

Client Service Representative (Billing) Part-Time

sequel technologies

Location: Chakwal, Pakistan Shift Timings: 5:00 PM &ndash; 2:00 AM (Night Shift) Position Type: Full-Time Experience Level: Senior / ExperiencedJob OverviewWe are seeking a Senior Billing Representative with strong expertise in medical billing and revenue cycle management (RCM) to join our growing team. The ideal candidate will have hands-on experience with US-based healthcare billing, excellent communication skills, and the ability to lead and mentor junior billing staff. This is a night-shift role (5 PM &ndash; 2 AM), suitable for candidates based in Chakwal.Key Responsibilities<ul><li>Manage the full-cycle medical billing process, including charge entry, payment posting, claim submission, and denial management.</li><li>Review and analyze EOBs (Explanation of Benefits) and handle AR (Accounts Receivable) follow-up effectively.</li><li>Ensure timely and accurate claim submissions to insurance companies.</li><li>Identify and resolve billing errors, rejections, and underpayments.</li><li>Collaborate with insurance companies, patients, and internal teams to resolve claim discrepancies.</li><li>Prepare and maintain accurate billing records, reports, and documentation.</li><li>Provide support and mentorship to junior billing representatives.</li><li>Maintain compliance with HIPAA and company confidentiality standards.</li><li>Contribute to process improvement and workflow efficiency.</li></ul>Qualifications &amp; Requirements<ul><li>Bachelor&rsquo;s degree (preferred) or equivalent experience in medical billing.</li><li>3+ years of experience in US medical billing, preferably with RCM companies.</li><li>Proficiency with medical billing software (e.g., Kareo, AdvancedMD, eClinicalWorks, Athena, or similar).</li><li>Strong understanding of CPT, ICD-10, and HCPCS coding.</li><li>Excellent communication skills (written and verbal) in English.</li><li>Strong analytical, problem-solving, and multitasking skills.</li><li>Resident of Chakwal (or willing to relocate).</li><li>Comfortable working night shifts (5 PM &ndash; 2 AM).</li></ul>What We Offer<ul><li>Competitive salary and performance-based incentives.</li><li>Growth and learning opportunities within the organization.</li><li>Supportive work environment with career advancement potential.</li><li>Paid training and professional development opportunities.</li></ul>Job Type: Full-timeWork Location: In person

Senior Billing Representative

Sanofi

Job Title : Senior Director, Transplant Access Strategy and Provider Accounts Location: Cambridge MA or Morristown, NJ About the Job The Sr Director, Transplant Market Access Strategy & Provider Accounts will lead a small team and be responsible for developing and implementing the short and long-term transplant market access strategy (positioning, pricing, contracting, pull-through plans) from start to end, for national/regional payers, institutions, channel customers, and patient support services. The candidate will utilize portfolio expertise and managed markets experience to build an integrated market access strategy based upon the brands strategies. The ability to identify key customer segments and generate customer insights is critical in this role. In addition, the role will define & implement inline and launch indication pricing strategy, MAx strategy, plan/tools, based on the global brand strategies. The incumbent will be responsible for transversally leading across diverse teams including Marketing, Market Access Shared Services, HEVA/RWE, PSS, Trade, Finance, Legal, manufacturing and logistics, and field sales. The candidate must have strong business acumen and outstanding communication and interpersonal skills to develop productive relationships across all internal and external customer groups. We are an innovative global healthcare company with a focus on immunology that extends to innovation in diabetes and transplant medicine. Across different countries, our talented teams are determined to deliver a best-in-class customer experience using the best of digital, artificial intelligence and personal know-how. With a focus on immunology that extends to innovation in diabetes and transplant medicines, we pursue progress to make a real impact on millions of patients around the world. Main Responsibilities: <ul><li> Partner effectively with support functions, Global Market Access and US teams to execute on MAx core deliverables (ex. specific market access or other tools). </li><li> Represent the access customer perspective within cross-functional, cross-regional commercialization teams including Brand, USMA, HEVA/RWE, Market Access Shared Services, PSS, Trade, Finance, Communications, Policy/Advocacy, and Public Affairs thereby optimizing the lifecycle of transplant products. </li><li> Partner with relevant departments (as listed above) to influence the market assessment, product positioning, and target product profile by providing strategic input regarding market access, reimbursement, and pricing information throughout the product lifecycle. </li><li> Participate in account discussions, as necessary, to communicate brand value, strategies, and market dynamics as they impact the product. </li><li> As a part of the broader global market access community, work closely with access professionals across the world ensuring consistent feedback and optimization of Global Value and Access deliverables including launch preparation, negotiations training, and contracting (including value-based and outcomes-based frameworks). </li><li> Develop market access strategies for future indications including generation of pricing recommendation, value proposition and messages, and detailed forecast assumptions, support strategies within depth market research, and environmental data & analogs as appropriate. </li><li> Partner closely with marketing on the assessment of business development/divestiture opportunities. </li><li> Monitor the marketplace for market access challenges, trends, threats & opportunities. </li><li> Partner closely with market access strategy colleagues within BU and across the organization to share best practices, customer insights and emerging trends. </li></ul> About You Basic Qualifications: <ul><li> BA/BS and 10+ years' relevant professional experience including market access, health economics, pricing & reimbursement </li><li> 10+ years' experience at local and/or international level w/ knowledge of US and Global market access & payer environment </li><li> Knowledge of disease market access desirable, but other backgrounds are welcomed. </li></ul> Preferred Qualifications: <ul><li> Proven track record of leading within a matrix environment to reach business objectives </li><li> Demonstrated ability to take on highly complex business problems, recommend strategic and tactical solutions in a simple and straightforward manner </li><li> Exhibits outstanding written and oral communication skills, including the ability to effectively write and deliver presentations to professionals at all levels within Sanofi </li><li> Demonstrated relationship building and team management at all levels of the organization and across geographies </li></ul> Travel: <ul><li> Approximately 10-20% </li></ul> The successful candidate will be required to sign and execute a restricted covenant upon hire. Why Choose Us?<ul><li>Bring the miracles of science to life alongside a supportive, future-focused team.</li><li>Discover endless opportunities to grow your talent and drive your career, whether it's through a promotion or lateral move, at home or internationally.</li><li>Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact.</li><li>Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks' gender-neutral parental leave.</li></ul>Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law. All compensation will be determined commensurate with demonstrated experience. Employees may be eligible to participate in Company employee benefit programs, and additional benefits information can be found here.<img src="https://www.jobg8.com/Tracking.aspx?WYz6RxUxrwFDUFZtS3M23V4eVO7DYp8%2fl" width="0" height="0" />

Senior Director, Transplant Access Strategy and Provider Accounts

Boston Scientific

<div>Additional Locations: N/A
Diversity - Innovation - Caring - Global Collaboration - Winning Spirit - High Performance
At Boston Scientific, we&rsquo;ll give you the opportunity to harness all that&rsquo;s within you by working in teams of diverse and high-performing employees, tackling some of the most important health industry challenges. With access to the latest tools, information and training, we&rsquo;ll help you in advancing your skills and career. Here, you&rsquo;ll be supported in progressing &ndash; whatever your ambitions.
Clinical Sales Representative (CSR), Watchman &ndash; MENA 
As a Clinical Sales Representative (CSR) for Boston Scientific&rsquo;s WATCHMAN Left Atrial Appendage Closure (LAAC) Device, you will play a critical role in driving procedural success, therapy adoption, and account development across the MENA region. This hybrid position combines expert clinical support with strategic sales engagement, directly influencing patient outcomes and long-term business growth. You&rsquo;ll partner closely with medical professionals, local distributors, and commercial teams to ensure excellence in clinical execution and commercial performance.
This role typically involves a time division of approximately 70% clinical and 30% sales activities. 
Your responsibilities will include:<ul><li> 
Provide expert clinical case support during WATCHMAN procedures, ensuring optimal product use and procedural efficiency.</li><li>
Educate physicians and cath lab staff on WATCHMAN use, patient selection, and procedural techniques through hands-on training and in-servicing.</li><li>
Act as the trusted clinical and technical contact for assigned accounts, building long-term relationships with medical management and staff.</li><li>
Collaborate with Regional Sales Managers (RSMs), Account Managers (AMs), and local distributors to support commercial and clinical goals.</li><li>
Identify, manage, and report clinical support-driven sales opportunities to the RSM; support the AM and RSM in clinical selling based on insights gathered.</li><li>
&ldquo;Sell the next case&rdquo; by ensuring customer satisfaction, supporting continuity, and driving sustained therapy usage.</li><li>
Contribute to the annual strategic planning process by providing RSM, NSM, and Marketing with detailed business intelligence&mdash;such as market size, product trends, clinical and economic stakeholder updates, and competitive landscape insights.</li><li>
Support RSMs in identifying unmet needs within accounts to facilitate the development of tailored account strategies.</li><li>
Record and manage customer activity and clinical insights via CRM systems to support regional business planning.</li><li>
Support market development initiatives including proctorships, peer-to-peer education, and local society engagement.</li><li>
Participate in key conferences and workshops as a clinical ambassador of the WATCHMAN business.</li><li>
Ensure full compliance with regulatory and quality system requirements in all support and training activities.</li></ul> 
Qualifications: 
Required qualifications:<ul><li>
Bachelor&rsquo;s degree in Life Sciences, Biomedical Engineering, Nursing, or a related field</li><li>
Minimum of 3 to 5 years' experience in a clinical or technical support role within medical devices, interventional cardiology, or structural heart</li><li>
Strong knowledge of cardiac anatomy, electrophysiology, or structural heart procedures</li><li>
Demonstrated ability to support procedures in cath labs and operating rooms under pressure</li><li>
Excellent communication, presentation, and stakeholder engagement skills</li><li>
Ability to travel frequently across the MENA region</li><li>
Fluent in English (Arabic and/or French is a strong advantage)</li><li>
Self-motivated and well-organized, with the ability to manage multiple priorities and accounts</li></ul> 
Preferred qualifications:<ul><li>
Experience supporting LAAC, EP, or structural heart devices</li><li>
Prior experience with WATCHMAN, LAAO, or competing technologies</li><li>
Experience working with physicians and hospitals in emerging markets</li></ul> 
Requisition ID: 616293 
As a leader in medical science for more than 40 years, we are committed to solving the challenges that matter most &ndash; united by a deep caring for human life. Our mission to advance science for life is about transforming lives through innovative medical solutions that improve patient lives, create value for our customers, and support our employees and the communities in which we operate. Now more than ever, we have a responsibility to apply those values to everything we do &ndash; as a global business and as a global corporate citizen. 
So, choosing a career with Boston Scientific (NYSE: BSX) isn&rsquo;t just business, it&rsquo;s personal. And if you&rsquo;re a natural problem-solver with the imagination, determination, and spirit to make a meaningful difference to people worldwide, we encourage you to apply and look forward to connecting with you!</div>

Clinical Sales Representative (CSR), Watchman - MENA

Placidway

PlacidWay is looking for an Inside Sales Representative - Provider Relations to manage and grow our global network of healthcare providers. This is a key role in helping providers enhance their performance, improve patient communication, and drive revenue growth. If you are passionate about building strong relationships, optimizing healthcare delivery, and making a tangible impact on patient journeys, we&rsquo;d love to hear from you.Key Responsibilities:<ul><li>Provider Support: Act as the primary point of contact for a portfolio of clinics and doctors, addressing inquiries, guiding them through processes, and escalating complex issues to the senior team.</li><li>New Provider Onboarding: Ensure a smooth transition for new providers, helping them integrate into the PlacidWay platform and optimize their profiles and services.</li><li>Administrative Tasks: Update client information in the CRM, prepare basic reports, and coordinate meetings or calls with providers.</li><li>Weekly Pipeline &amp; Performance Management: Help providers manage their weekly patient inquiry pipeline, tracking progress and identifying areas for improvement. Provide actionable insights and recommendations to boost conversion rates and drive performance.</li><li>Client Relationships: Maintain strong relationships with clinics and doctors, ensuring their satisfaction and fostering long-term collaboration.</li><li>Patient Communication Enhancement: Collaborate with providers to refine their patient communication strategies, ensuring responsiveness and personalization in every interaction. Share best practices to enhance patient satisfaction and engagement and reach out to patients if needed.</li><li>Revenue Generation &amp; Sales Optimization: Identify opportunities to maximize revenue for providers through upselling and cross-selling initiatives. Monitor sales metrics and suggest data-driven strategies for continuous improvement.</li><li>Continuous Improvement: Identify opportunities to optimize internal processes, the provider experience, and sales strategies.</li></ul>Required Skills and Experience:<ul><li>Experience: 1&ndash;5 years in customer support, sales, account management, or similar roles. Recent graduates with relevant internship experience are also considered.</li><li>Proficiency in written and spoken English (required).</li><li>Basic knowledge of CRM platforms (Salesforce, HubSpot, or similar) is a plus.</li><li>Proficiency in Microsoft Office or Google Workspace.</li><li>Highly organized and detail-oriented.</li><li>Proactive and solution-focused.</li><li>Empathetic and customer/provider-centric.</li><li>Strong teamwork and interpersonal skills.</li><li>Eagerness to learn and adaptability to new challenges.</li></ul>Compensation and Benefits:<ul><li>Salary base: per month, plus commissions and bonuses.</li><li>Benefits:</li><li>Paid Time Off (PTO) for personal matters, celebrations, or emergencies.</li><li>Professional development opportunities and continuous learning.</li><li>Work Status: This is a fully remote position. Full-time (8 Hours per day) Monday to Friday.</li></ul>Ready to lead and grow with us?Apply now with your CV in English and join our dynamic team in the medical tourism industry, where your leadership will make a significant impact on the growth and success of the company.Job Type: Full-timeExperience:<ul><li>B2C Sales: 1 year (Required)</li><li>remote work: 1 year (Required)</li><li>account management: 1 year (Required)</li></ul>Language:<ul><li>English (Required)</li></ul>

Inside Sales Representative

Regional Cancer Care Associates LLC

<div>Overview:
<h3 class="jobSectionHeader">Join RCCA as an Insurance Specialist &ndash; Make a Meaningful Impact Every Day</h3><div>
Are you detail-oriented, driven, and passionate about making a difference in healthcare? RCCA is looking for an Insurance Specialist to help ensure our patients receive the care they need without financial barriers. In this vital role, you&rsquo;ll be at the heart of our revenue cycle operations, helping maintain accurate and timely account resolutions.</div><div></div><div> 
Employment Type: Full Time</div><div>
Location: Hackensack, NJ</div><div>
Compensation: $19.50 - $26.29 per hour</div><div>
Compensation packages based on your unique skills, experience, and qualifications</div><div></div><div> 
As of the date of this posting, RCCA offers a comprehensive benefits package for this position, subject to eligibility requirements. In addition to the salary, we provide: Health, dental, and vision plans, Wellness program, Health savings account - Flexible spending accounts, 401(k) retirement plan, Life insurance, Short-term disability insurance, Long-term disability insurance, Employee Assistance Program (EAP), Paid Time Off (PTO) and holiday pay, Tuition discounts with numerous universities.</div><div></div><div> 
We believe these benefits underscore our commitment to the well-being and professional growth of our employees.</div> 
<div></div>
Responsibilities:
<div>
Monitors delinquent accounts and performs collection duties 
<ul><li>Reviews reports, identifies denied claims, researches and resolves issues, may perform a detailed reconciliation of accounts, and resubmits claim to payer</li><li>Reviews payment postings for accuracy and to ensure account balances are current</li><li>Works with co-workers to resolve payment and billing errors</li><li>Monitors and updates delinquent accounts status</li><li>Recommends accounts for collection or write-off
</li><li>Verifies existing patients have necessary referral and/or authorization documentation prior to examination date</li><li>Contacts and follows up with patient&rsquo;s physician for any missing or incomplete documentation</li><li>Contacts patients to secure past due balances, verifies patient demographics and insurance providers, updates information in systems, and documents conversations</li><li>Answers patient payment, billing, and insurance questions and resolves complaints</li><li>May refer patients to Patient Benefits Representative to set up payment plans</li><li>Contacts third party payors to resolve payor issues, expedite claim processing, and maximize medical claim reimbursement</li><li>Maintains credit balances of patients and payors ensuring timely refunds within government guidelines/regulations</li><li>Adheres to confidentiality, state, federal, and HIPPA laws and guidelines with regard to patient records
</li><li>Performs other duties as requested or assigned</li></ul></div>
Qualifications:
<ul><li>High School diploma or equivalent required</li><li>
Minimum four (4) years combined medical billing and payment experience required
</li><li>Demonstrate knowledge of medical coding, preferably oncology coding
</li><li>Demonstrate knowledge of state, federal, and third party claims processing required
</li><li>Demonstrate knowledge of state &amp; federal collections guidelines</li><li>
Must successfully complete required e-learning courses within 90 days of occupying position 
 
COMPETENCIES 
<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>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><li>Makes decisions under conditions of uncertainty</li><li>Shows Work Commitment</li><li>Sets high standards of performance</li><li>Pursues aggressive goals and works efficiently to achieve them</li><li>Commits to Quality</li><li>Emphasizes the need to deliver quality products and/or services</li><li>Defines standards for quality and evaluates products, processes, and services against those standards</li><li>Manages quality</li><li>Improves efficiencies</li></ul> 
PHYSICAL DEMANDS 
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations will be offered to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is required to be present at the employee site during regularly scheduled business hours and regularly required to sit or stand and talk or hear. The position requires full range of body motion including handling and lifting patients, manual and finger dexterity, and eye-hand coordination. The position requires standing and walking for extensive periods of time. The employee occasionally lifts and carries items weighing up to 40 lbs. The position requires corrected vision and hearing to normal range.
 
 
WORK ENVIRONMENT 
The work environment may include exposure to communicable diseases, toxic substances, ionizing radiation, medical preparations and other conditions common to an oncology/hematology clinic environment. Work will involve in-person interaction with co-workers and management and/or clients. Work may require minimal travel by automobile to office sites.</li></ul></div><div></div>

Insurance Specialist

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