Billing Specialist jobs at LifePoint Health - 8887 jobs

Full Time 36 hours/week 7pm-7am onsite The Supervisor Patient Care is responsible for nursing operations and patient care delivery across multiple units during assigned shifts. This role is responsible for staffing management and coordination among hospital departments. The Supervisor collaborates with the Transfer Center for patient placement and throughput, responds to emergencies and codes, and activates the Hospital Emergency Incident Command, when necessary, potentially serving as the Incident Commander Responsibilities: 1.Understands the business, financials industry trends, patient needs, and organizational strategy. 2.Provides support and assistance to nursing staff to ensure adherence to patient care protocols and quality standards. 3. Assist in monitoring the department budget and helps maintain expenditure controls. 4. Promotes and maintains quality care by supporting nursing staff in the delivery of care during assigned shifts. 5. Visits patient care units to assess patient conditions, evaluates staffing needs and provides support to caregivers. 6. Communicates with the appropriate Nursing Management staff member [VP of Patient Services, Directors of Nursing and Nurse Managers] about any circumstances or situations which has or may have serious impact to patients, staff or hospital. 7. Assist in decision-making processes and notifies the Administrator on call when necessary. 8. Collaborates with nursing and hospital staff to ensure the operational aspects of patient care units are maintained effectively. 9. Supports the nursing philosophy and objectives of the hospital by participating in educational efforts and adhering to policies and procedures. 10. Other duties as assigned. Other information: Technical Expertise 1. Experience in clinical pediatrics is required. 2. Experience working with all levels within an organization is required. 3. Experience in healthcare is preferred. 4. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Education and Experience 1. Education: Graduate from an accredited School of Nursing; Bachelor of Science in Nursing (BSN) is required. 2. Licensure: Currently licensed to practice nursing as a Registered Nurse in the State of Ohio is required. 3. Certification: Current Health Care Provider BLS is required; PALS, NRP, ACLS or TNCC is preferred. 4. Years of relevant experience: Minimum 3 years of nursing experience required. 5. Years of supervisory experience: Previous Charge Nurse, Clinical Coordinator, or other leadership experience is preferred. Full Time FTE: 0.900000 Status: Onsite

If you are looking to make an impact on a meaningful scale, come join us as we embrace the Power of One! We strive to be an employer of choice and establish a reputation for being a talent rich organization where Associates can grow their career caring for others. For over a century, we've served the health care needs of the people of Memphis and the Mid-South. Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values. Working at MLH means carrying the mission forward of caring for our community and impacting the lives of patients in every way through compassion, a deliberate focus on service expectations and a consistent thriving for excellence. A Brief Overview Responsible for precertification of eligible prescriptions. Ensures complete documentation is obtained that meets insurer guidelines for medical necessity and payment for services. Models appropriate behavior as exemplified in MLH Mission, Vision and Values. What you will do Responsible for precertification of eligible prescription medications for inpatient and outpatient services based on medical plan documents and medical necessity. Ensures medical documentation is sufficient to meet insurer guidelines for medical necessity documentation and procedure payment. Reviews clinical information submitted by medical providers to evaluate the necessity, appropriateness and efficiency of the use of prescription medications. Assists with patient assistance and grant coordination for Patients for outpatient pharmacies from designated areas. Proactively analyzes information submitted by providers to make timely medical necessity review determinations based on appropriate criteria and standards guidelines. Verifies physician orders are accurate. Determines CPT, HCPCS and ICD-10 codes for proper Prior Authorization. Contacts insurance companies and third party administrators to gather information and organize work-flow based on the requested procedure. Collects, reads and interprets medical documentation to determine if the appropriate clinical information has been provided for insurance reimbursement and proper charge capture. Serves as primary contact with physicians/physician offices to collect clinical documentation consistent with insurer reimbursement guidelines. Establishes and maintains rapport with providers as well as ongoing education of providers concerning protocols for pre-certification. Communicates information and acts as a resource to Patient Access, Case Management, and others in regard to contract guidelines and pre-certification requirements. Performs research regarding denials or problematic accounts as necessary. Works to identify trends and root cause of issues and recommend resolutions for future processes. Education/Formal Training Requirements High School Diploma or Equivalent Work Experience Requirements 3-5 years Pharmacy (clinical, hospital, outpatient, or specialty) Licenses and Certifications Requirements See Additional Job Description. Knowledge, Skills and Abilities Basic understanding of prescription processing flow. Expertise in utiliizing EMRs to document clinical critieria required for third party approval. Knowledgeable of medical terminology, drug nomenclature, symbols and abbreviations associated with pharmacy practice. Strong attention to detail and critical thinking skills. Ability to speak and communicate effectively with patients, associates, and other health professionals. Ability to diagnose a situation and make recommendations on how to resolve problems. Experience with a computerized healthcare information system required. Familiarity with fundamental Microsoft Word software. Excellent verbal and written communication skills. Supervision Provided by this Position There are no lead or supervisory responsibilities assigned to this position. Physical Demands The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion. Must have good balance and coordination. The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently. The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading. The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative. Our Associates are passionate about what they do, the service they provide and the patients they serve. We value family, team and a Power of One culture that requires commitment to the highest standards of care and unity. Boasting one of the South's largest medical centers, Memphis blends a friendly community, a thriving and growing downtown, and a low cost of living. We see each day as a new opportunity to make a difference in the lives of the people in our community.

PRN Night shift 7pm-7:30am onsite The Supervisor Patient Care is responsible for nursing operations and patient care delivery across multiple units during assigned shifts. This role is responsible for staffing management and coordination among hospital departments. The Supervisor collaborates with the Transfer Center for patient placement and throughput, responds to emergencies and codes, and activates the Hospital Emergency Incident Command, when necessary, potentially serving as the Incident Commander Responsibilities: 1.Understands the business, financials industry trends, patient needs, and organizational strategy. 2.Provides support and assistance to nursing staff to ensure adherence to patient care protocols and quality standards. 3. Assist in monitoring the department budget and helps maintain expenditure controls. 4. Promotes and maintains quality care by supporting nursing staff in the delivery of care during assigned shifts. 5. Visits patient care units to assess patient conditions, evaluates staffing needs and provides support to caregivers. 6. Communicates with the appropriate Nursing Management staff member [VP of Patient Services, Directors of Nursing and Nurse Managers] about any circumstances or situations which has or may have serious impact to patients, staff or hospital. 7. Assist in decision-making processes and notifies the Administrator on call when necessary. 8. Collaborates with nursing and hospital staff to ensure the operational aspects of patient care units are maintained effectively. 9. Supports the nursing philosophy and objectives of the hospital by participating in educational efforts and adhering to policies and procedures. 10. Other duties as assigned. Other information: Technical Expertise 1. Experience in clinical pediatrics is required. 2. Experience working with all levels within an organization is required. 3. Experience in healthcare is preferred. 4. Proficiency in MS Office [Outlook, Excel, Word] or similar software is required. Education and Experience 1. Education: Graduate from an accredited School of Nursing; Bachelor of Science in Nursing (BSN) is required. 2. Licensure: Currently licensed to practice nursing as a Registered Nurse in the State of Ohio is required. 3. Certification: Current Health Care Provider BLS is required; PALS, NRP, ACLS or TNCC is preferred. 4. Years of relevant experience: Minimum 3 years of nursing experience required. 5. Years of supervisory experience: Previous Charge Nurse, Clinical Coordinator, or other leadership experience is preferred. On Call FTE: 0.001000 Status: Onsite

The ECMO Specialist is enrolled and actively participating in the department's ECMO Training Program. This role is responsible for developing and maintaining the skills necessary to proficiently and safely establish, manage, and control extracorporeal membrane oxygenation (ECMO) technology and assist with associated procedures in acutely ill patients of all ages in critical care settings. The specialist will learn to troubleshoot devices and associated equipment under the supervision of experienced ECMO personnel, provide ongoing care through surveillance of clinical and physiologic parameters, adjust ECLS devices as needed, administer and document blood products and medications in accordance with hospital standards, provide airway and ventilator management, and perform the full scope of practice of a Respiratory Therapist II. Schedule: 36 hours per week, rotating day/night shifts, every third weekend. **This position is eligible for full time benefits $20,000 sign-on bonus (not eligible for internal candidates and not eligible for former BCH employees who worked here in the past 2 years) Key Responsibilities: Assemble, prepare, and maintain extracorporeal circuits and associated equipment with assistance. Assist in priming extracorporeal circuits and preparing systems for clinical application. Assist with cannulation procedures. Assist in establishing extracorporeal support; monitor patient response, provide routine assessments, circuit evaluations, patient monitoring, and anticoagulation management. Assist with ECMO circuit interventions, weaning procedures, and transports. Administer blood products per hospital standards. Interact and communicate with caregivers, nursing, surgical and medical teams, patients, and family members. Maintain relevant clinical documentation in the patient's electronic health record. Participate in professional development, simulation, and continuing education. Attend ECMO Team meetings and M&M conferences on a regular basis. Minimum Qualifications Education: Required: Associate's Degree in Respiratory Therapy Preferred: Bachelor's Degree Experience: Required: A minimum of one year of experience as a BCH Respiratory Therapist with eligibility for promotion to RT II, or one year of external ECMO experience Preferred: None specified Licensure / Certifications: Required: Current Massachusetts license as a Respiratory Therapist Required: Current credential by the National Board of Respiratory Care as a Registered Respiratory Therapist (RRT); Neonatal Pediatric Specialist (NPS) credential must be obtained within 6 months of entry into the role Preferred: None specified The posted pay range is Boston Children's reasonable and good-faith expectation for this pay at the time of posting. Any base pay offer provided depends on skills, experience, education, certifications, and a variety of other job-related factors. Base pay is one part of a comprehensive benefits package that includes flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

New York City Health and Hospitals Corporation Outposted Therapeutic Housing Units Program (OTxHU) Since 2016, Correctional Health Services (CHS) has been the direct provider of health care in the New York City jails. Deeply committed to human dignity and patient rights, CHS is part of the NYC Health + Hospitals system and is a key partner in the City's efforts to reform the criminal-legal system. Our in-jail clinical services include medical, nursing, and mental health care; pharmacy services; substance-use treatment; social work; dental and vision care; discharge planning; and reentry support. Given the high visibility of this initiative, we are seeking the highest caliber health care professionals in key clinical services to staff our Outposted Therapeutic Housing Units (OTxHU). To be located in three NYC Health + Hospital acute care facilities, the OTxHU is a pioneering approach to safely increasing access to high quality clinical care for patients in custody who have complicated health conditions. OTxHUs will bridge the gap in the continuum between care provided in the jails and inpatient hospitalization, with admission to and discharge from the OTxHU in accordance with a patient's clinical needs. CHS will be the primary health care providers on these units and the NYC Department of Correction will provide security and custody management. The OTxHU at NYC Health + Hospitals/Bellevue in Manhattan will be the first of this unique, groundbreaking project to open with a planned completion date as early as the end of 2024. This is an incredible opportunity to be part of a passionate and motivated team providing care to some of the City's most marginalized, vulnerable people. *To help support continuity of operations and care, staff selected to work in the OTxHU may also be required to work in CHS locations within the jails. Additionally, while CHS seeks the most qualified individuals for these positions, preference will be given to equally qualified, internal candidates. Time: 08:00 AM - 05:00 PM Days: Mon,Tue,Wed,Thu,Fri Location: OTxHU- Bellevue/Rikers Island Under supervision of the Site Medical Director, the Physician will provide comprehensive, compassionate, and thoughtful care to patients with complex chronic disease in the New York City jail system. The Physician will be part of a core interdisciplinary team working in a unique environment delivering the care to patients with significant chronic illnesses. The Physician will provide general primary care including conducting histories and physicals, diagnosing and treating acute and chronic illnesses, and evaluating the need for consult services. The interdisciplinary team will work under supervision of a Site Medical Director. Responsibilities include: Diagnose and treat acute and chronic illnesses. Evaluate the need for consult services and submit the prioritized consult when indicated. Complete comprehensive histories and physicals on all new admissions including documentation of problem list, diagnosis, orders (e.g. labs, imaging and referrals) and ordering appropriate medications where applicable. Evaluate patients requesting sick call, schedule follow-ups and update medication orders. Update problem lists and reconcile patient orders at all visits. Implement plans for patient care utilizing protocols approved by the medical leadership and/or treatment plans reflecting the current standard of care. Request radiology exams, lab tests, EKGs when clinically indicated and interpret these results based on clinical findings and in consultation with supervisors where appropriate. Collaborate closely with CHS Physician Assistants, including providing clinical guidance, cosigning notes, and providing other supervision based on clinical circumstance and PA requirements. Review all specialty consults and hospital returns to ensure that the standard of care is met and recommendations of the consultant are implemented. Perform chart reviews and summaries for patients transferring facilities including updating problem lists, rewriting medication orders, and reconciling orders and consults as needed. Generate special needs referrals and documentation as needed (for patients with (disabilities, dietary restrictions, heat sensitivity, or other relevant flags). Teach patients about their medical conditions and treatments; counsel on risks and benefits of different treatment decisions; witness, sign, and document patient refusals of care. Ensure that all progress notes and orders are signed before the end of the shift. Respond to emergencies in a timely and professional manner. Notify the appropriate parties, including Urgicare, about 3-hour runs and EMS activation. Complete special housing rounds when assigned. Be familiar with quality of care and population health indicators. Take appropriate action to meet or exceed standards. Maintain clinical competency by participating in all CME and CHS training and in-service requirements. Maintain your schedule as directed with particular attention to punctuality and timely notification of absences. Adhere to policies and procedures of CHS and be familiar with them by reviewing them as needed. Complete tasks as delegated by a Site Medical Director or other supervising clinical team member. Maintain all required credentials. Maintain current licensure and CME requirements (Appropriate documentation must be on our files). Maintain professional attitude and appearance. Adhere to Occupational Health Services requirements. Minimum Qualifications 1. Graduation from an approved medical school. 2. Completion of approved residency or fellowship in the specialty or sub-specialty and Board eligible or certified or Subboard eligible or certified. 3. Five years experience in field of specialty or subspecialty acceptable to the Medical Board of the Hospital. 4. Licensed to practice medicine in the State of New York. Department Preferences Three to five years' work experience, which may include residency in a directly related medical specialty Experience working with patients in a skilled nursing facility or other residential setting Experience working with patients who have serious mental illness Experience working with patients who carry substance use diagnoses; knowledge of harm reduction approaches to care; and familiarity with medications to treat opioid use disorder Experience leading quality improvement initiatives Understanding of trauma-informed care Skilled in patient-centered shared decision making Skilled in communicating risks and benefits of clinical interventions and assessing capacity to make informed decisions. Completion of residency in internal medicine, family medicine or other primary care-oriented specialty. Compliance with appropriate Maintenance of Certification requirements or other Board Certification requirements. Excellent interpersonal communication skills and ability to work collaboratively within a multidisciplinary team, as well as with NYC DOC staff NYC Health and Hospitals offers a competitive benefits package that includes: Comprehensive Health Benefits for employees hired to work 20+ hrs. per week Retirement Savings and Pension Plans Paid Holidays and Vacation in accordance with employees' Collectively bargained contracts Loan Forgiveness Programs for eligible employees College tuition discounts and professional development opportunities College Savings Program Union Benefits for eligible titles Multiple employee discounts programs Commuter Benefits Programs

Job Posting Description Key Responsibilities for the Sr. Patient Experience Representative: Demonstrates effective and empathetic customer service that supports departmental and hospital operations. Responds to patient needs and escalated concerns, ensuring a high-quality experience and timely resolution. Greets, screens, and directs patients, families, and visitors; monitors clinic flow to optimize the patient experience. Registers new patients and verifies demographic, insurance, and referral information. Obtains authorizations and referrals, enters billing and treatment codes, reconciles payments, and prepares deposits. Schedules patient appointments and procedures across providers and departments. May rotate into call center roles; communicate with referring providers and practices to facilitate patient management. Trains, orients, and cross-trains staff on departmental systems, policies, and procedures. Enrolls patients and caregivers in the patient portal and ensure staff is informed of customer service and IT system updates. Participates in and contributes to departmental initiatives, recommending and implementing process improvements. Minimum Qualifications Education: High School Diploma or GED required Experience: Minimum 1 year of administrative, front desk or related healthcare experience required. PER positions are currently eligible for a Sign-on Bonus of $2,000 for full time positions (not eligible for internal candidates and not eligible for former BCH employees who worked here in the past 12 months) Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, childcare and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.

Job Posting Description The Senior PER monitors clinic activity to ensure an optimal patient experience and resolves customer service and scheduling issues. They provide effective service support, obtain and record required authorizations, and manage daily schedules to optimize workflow. Responsibilities include answering and triaging calls, routing messages, providing routine information, and initiating emergency services when needed. The role also contributes to staff training on department processes and technology, demonstrates strong problem-solving and teamwork skills, and supports continuous process improvement initiatives. Key responsibilities Customer Service Provides positive, effective customer service to patients, families, visitors, and referring providers. Greets, screens, directs, and responds to routine inquiries on hospital protocols. Addresses escalated or complex issues and collaborates to resolve patient concerns. May rotate through call center functions. Patient Registration / Admissions / Discharge Collects basic vitals (H/W/T) and completes EMR questionnaires as needed. Monitors clinic flow and supports optimal patient experience. Registers new patients; verifies and processes demographics, insurance, referrals, authorizations, and required documentation. Assists with room preparation and routine clinical support tasks. Supports billing processes: coding entry, collecting copays, reconciling payments, and preparing deposits. Coordinates with Financial Counseling and other departments for administrative or insurance-related needs. Scheduling Schedules appointments and procedures across providers and departments. Monitors and adjusts daily schedule to optimize flow; communicates with clinicians and supervisors as needed. Patient Flow Coordination Participates in shift handoffs and team huddles to support coordinated care. Administration Manages calendars, schedules meetings/events, and supports conferences and department programs. Prepares documents, presentations, requisitions, and standard forms. Triages calls, routes urgent requests, and initiates emergency services when required. Provides routine clerical support (mail, copying, distributing materials, organizing medical records). Processes letters, external requests, and prescription refills. Training Participates in and supports staff training on systems, workflows, and customer-service practices. Trains and cross-trains staff; serves as resource for operations, billing/payer requirements, and problem resolution. Technology Uses phone systems, email, Microsoft Office, and clinical/scheduling/billing applications. Enrolls patients and caregivers in the patient portal. Process Improvement Contributes to departmental and organizational improvement initiatives. Recommends and helps implement updates to systems and procedures. Minimum qualifications Education: High School Diploma / GED Experience: Minimum of 1 year as a PER or related healthcare experience. Serves as a go-to resource and handles complex questions independently. Coaches others by translating complex information into clear, simple terms. Completes tasks reliably; seeks expert input only when needed. Explains the impact of process and policy changes on patient experience. Anticipates needs and communicates clearly using non-technical language. Builds strong working relationships across teams. Communicates effectively and empathetically, both verbally and in writing. Works well with diverse internal and external stakeholders. Schedule: Monday - Friday , Hybrid- 4 days onsite

We are seeking a skilled and strategic Billing Manager to lead and oversee the daily operations of a healthcare billing department. This role is responsible for managing billing workflows, supervising staff, and ensuring accurate and timely claims processing across multiple insurance types. The ideal candidate will bring leadership experience, a deep understanding of revenue cycle operations, and a commitment to driving performance and compliance. Key Responsibilities: Supervise and mentor a team of billing professionals, promoting a culture of accountability, collaboration, and continuous improvement. Oversee departmental operations including claims submission, denial management, and revenue tracking. Ensure billing processes align with regulatory standards and payer requirements, including Medicare, Medicaid, and commercial insurance. Develop and maintain training programs and standard operating procedures (SOPs) for billing staff. Monitor team performance, conduct evaluations, and support professional development. Collaborate with finance and HR leadership to manage staffing, attendance, and disciplinary actions. Lead recruitment efforts for billing roles, including candidate screening and interview participation. Identify and resolve system issues in coordination with software vendors and payers. Analyze accounts receivable (A/R) aging reports, identify trends, and implement corrective actions to improve collections. Track key performance indicators (KPIs) and generate reports to support strategic decision-making. Ensure timely filing and clean claim submission to maximize revenue and minimize rejections. Respond to audit findings and implement process improvements to reduce billing and coding errors. Maintain compliance with HIPAA regulations and uphold patient confidentiality standards. Provide exceptional internal and external customer service and maintain a positive team environment. Qualifications: Associate's or Bachelor's degree in healthcare administration, business, finance, or a related field preferred. Equivalent experience will be strongly considered. Medical Billing Certification preferred. Minimum of 3-5 years of experience in healthcare billing or revenue cycle management, with at least 2 years in a supervisory or leadership role. Strong knowledge of insurance billing practices, denial management, and regulatory compliance. Proficiency in billing software and data analysis tools. Excellent communication, organizational, and problem-solving skills. Benefits: Competitive salary Health, dental, and vision insurance Paid time off and holidays Retirement plan options Professional development opportunities

Under the direction of the Revenue Cycle Manager, the Billing Specialist will be responsible for accurate and timely billing processes, including preparing and submitting claims, resolving denials, and ensuring compliance with FQHC regulations, while also assisting patients with billing inquiries. The Billing Specialist will understand and model the mission of Bond CHC. Successful performance of job duties will directly impact health system goals to obtain appropriate reimbursement and compensation for services rendered by professional staff. The Billing Specialist will ensure and maintain all records in compliance with HIPAA. Requirements DUTIES AND RESPONSIBILITIES: 1. Process daily the medical and dental billing for Bond CHC patients. 2. Timely follow up on insurance claim denials, exceptions or exclusions. 3. Ensure compliance with all regulatory requirements related to FQHC billing. 4. Work with various third-party payers to resolve billing issues. 5. Respond to inquiries from insurance companies, patients and providers. 6. Ensure that all financial documents received by patients during collection activities are appropriately scanned in patient accounts. 7. Coordinate with the Revenue Cycle Manager on any back billing and/or account adjustments necessary due to financial documentation presented by patients during collection activities. 8. Actively participate in internal quality improvement teams. Works with members proactively to support quality improvement initiatives in accordance with the mission and strategic goals of the organization, federal and state laws and regulations, and accreditation standards. 9. Do other duties as assigned. QUALIFICATIONS A high school graduate or equivalent. At least one year experience in a medical health care organization performing medical or dental billing activities or working with patient accounts. Ability to operate a computer including internet for accessing insurance plan web portals. Well organized, friendly, courteous, adaptable, dependable and patient. Must have ability to work well under pressure and be an effective communicator. A high degree of maintaining confidentiality. Clerical experience with ability to compose letters, contact patients and other professional organizations by telephone in a manner representing the organization's mission and goals. Prerequisites for the positions generally include a clean criminal background check and drug test.

Spooner Medical Administrators, Incorporated (SMAI) is a family owned and operated company that offers rewarding career opportunities for motivated individuals who are passionate about excellence and growth. Since 1997, SMAI's proactive philosophy and best practices have set the standard in workers' compensation by continuously improving the delivery of case management, utilization review and billing services to help facilitate a successful return to work for the injured worker. The Billing Specialist is primarily responsible for reviewing, auditing and data entry of bills submitted by medical providers for compliance with proper billing practices. Essential Functions Review bills to determine if the information needed to process the bill has been received and contact the medical provider for any missing information. Perform fee bill audits according to established procedures and guidelines. Data enter fee fills accurately for electronic transmission. Adhere to established billing performance requirements. Review electronic response to transmitted bills and make modifications accordingly. Respond to telephone inquiries from customers regarding bill payment status. Participate in continuous improvement activities and other duties as assigned. Supervision Received Reports to the Billing Supervisor Experience and Education Required Medical billing certification or at least 2 years of experience working in the medical billing field Data entry experience Additional Skills Needed Effective written and verbal communication Detail oriented Strong organizational ability Basic computer literacy skills Working Environment The work environment characteristics described herein are representative of those an employee encounters while performing the essential functions of the job. While performing the duties of this job, the employee typically works in a normal office environment. The noise level in the work environment is usually quiet.

Requisition #: 7401 # of openings: 1 Employment Type: Full time Permanent Category: Non-Bargaining Workplace Arrangement: Hybrid Fund: 1199SEIU National Benefit Fund Job Classification: Non-Exempt Responsibilities • Assist and educate 1199SEIU members and providers with out-of-network fees and out of pocket expenses on the contracts and benefits of using the Funds network • Negotiate and resolve large volume of balance billing inquires fees and discounts for members with non-participating providers via telephone and written correspondence; maintain ongoing communication with providers, members, attorneys, or collection agencies to resolve balance billing/fee negotiation inquiries • Proactively negotiate claims impacted by the No Surprises Act (NSA), focusing on resolving disputes with out-of-network providers to avoid escalation to Independent Dispute Resolution (IDR). This includes leveraging communication and negotiation strategies to achieve mutually agreeable payment solutions. Assess claim details and potential outcomes to determine when negotiation is more beneficial than escalating to IDR, utilizing various benchmarks • Utilize the various databases to assess and compute reasonable rates, negotiating claim payments with providers, attorneys, and collection agencies on behalf of members • Proactively identify and communicate any barriers to achieving departmental objectives to management • Analyze received correspondence; verify member eligibility, claim history and coordination of benefits • Identify billing anomalies and alert the appropriate departments to reduce potential fraudulent billing practices. • Review claims to assess if appropriate action was taken and collaborate with various departments to implement corrections • Research provider contracts and lease network reports to ensure providers are not breaching contracts by referring members out of network; report noncompliant providers to the Network Management and Contracting departments • Identify potential opportunities to contract providers and refer to the Network Management and Contracting departments • Triage balance billing/fee negotiation inquiries and ensure all documents are processed in a timely and efficient manner • Perform special projects and other duties assigned by management Qualifications • High School Diploma required, Associate degree or equivalent's degree highly preferred • Minimum two (2) years of hospital and medical claims processing experience, including at least two (2) years of negotiation experience required. • Proficient in math skills and the ability to perform calculations for negotiations are required • Strong knowledge of health claims, eligibility rules, and Coordination of Benefits (COB) is necessary • Basic understanding of the No Surprises Act (NSA), including experience with surprise billing protections, Independent Dispute Resolution (IDR) processes, and the Qualified Payment Amount (QPA) • Excellent critical thinking, attention to detail, and problem-solving skills; able to work independently and collaboratively as part of a team • Demonstrate analytical and organizational skills with the ability to multitask and meet operational deadlines • Proficiency in Microsoft Office (Word, Excel, Outlook, etc.). Ability to grasp and utilize new software systems • Ability to work well under pressure, maintain a professional manner, and presentation

Purpose: This position is responsible for all phases of client billing, which may include: performing edits, billing, write-offs, and time transfers. Essential Job Functions: 1. Print and distribute pre-bills monthly to billing attorneys. 2. Edit invoices monthly in a timely manner based on comments received from billing attorneys. 3. Invoice and bill clients in the accounting system each month in a timely manner. This includes clients that are billed electronically. 4. Perform client and matter changes within the accounting system. 5. Process write-offs within the accounting system in accordance with company policy. 6. Work with clients and attorneys in a timely manner to answer inquiries and provide analysis of billings. 7. Perform other tasks as assigned. Required Qualifications: Knowledge, Skills, Abilities and Personal Characteristics 1. High attention to detail; organized. 2. Developed knowledge of basic billing knowledge. 3. Effective interpersonal skills; strong oral and written communication skills. 4. High degree of initiative and independent judgment. 5. Computer skills: accounting system (3E experience preferred), word processing, and spreadsheet capabilities.

- 2 days in office Pay Range: $23-$25/hr. Behavioral Health Group (BHG) is the largest network of Joint Commission-accredited treatment centers and a leading provider of opioid addiction treatment services. With over 116 locations in 24 states and a team of more than 1,900 employees, we are dedicated to helping individuals overcome substance use disorders and reclaim their lives. Join us in making a difference. Job Summary This position will act as a key member of the Revenue Cycle Department and reports to the Director, Contract and Revenue Cycle. The Revenue Cycle Specialist will help facilitate claims, payments, and verifications daily. The Revenue Cycle Specialist will provide updates and reports on the financial stability of the treatment centers. Summary of Essential Job Functions The key responsibilities of the Revenue Cycle Specialist include but not limited to: Duties and Responsibilities Reviews claims data to ensure 3rd party billing requirements are met Reviews claims to ensure eligibility, prior authorizations and proper signatures Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs Medicaid, VA, etc.) Investigates denied claims through research and applicable correspondence and follows through to resolution Successfully resolves payment discrepancies in a timely manner Escalates issues appropriately and promptly to supervision Verifies and informs treatment center staff about the patient's financial accountability and 3rd party reimbursement, as applicable Posts payments and adjustments while ensuring all deposits are balanced daily Documents payment records and issues as they occur Completes reporting requirements as required by company policy and requested by supervision Demonstrates an understanding of NPI, taxonomy and electronic claim submission requirements Identifies underpayments and overpayments/credits to determine steps for resolution Retrieves missing payment information from payers through various methods (phone, payer portals, clearing houses, etc.) Reads debits and credits on accounts and takes necessary action to resolve Performs other duties assigned by supervision Regulatory Responsible for complying with all federal, state and local regulatory agency requirements Responsible for complying with all accrediting agencies Marketing and Outreach Participate in community and public relations activities as assigned. Professional Development Responsible for the achievement of assigned specific annual goals and objectives Demonstrates the belief that addiction is a brain disease, not a moral failing Demonstrates hope, respect, and caring in all interactions with patients and fellow Team Members Establishes and maintains positive relationships in the workplace Can work independently and under pressure while handling multiple tasks simultaneously Makes decisions and uses good judgment with confidential and sensitive issues Deals appropriately with others in stressful or other undesirable situations Training Participate in and provide in-service trainings as required by federal, state, local, and accrediting agencies Attend conferences, meetings and training programs as directed Participate in and/or schedule and attend regular in-service trainings Other Demonstrated commitment to valuing diversity and contributing to an inclusive working and learning environment Minimum Requirements The Revenue Cycle Specialist will be responsible for reviewing claims data to ensure insurance requirements, eligibility, prior authorizations and proper signatures are secured prior to submission. Submits claims in an organized sequence in order to achieve reimbursement from private payers, insurance companies and government healthcare programs with heavy concentration in Medicaid. Will investigate declined claims through research and applicable correspondence in order to successfully resolve payment discrepancies. Qualifications The Revenue Cycle Specialist must have the following qualifications. High school Diploma or equivalent In addition to meeting the qualifications, the ideal candidate will embody the following characteristics and possess the knowledge, skills and abilities listed below: Denial Management Skillset Strong knowledge of Excel High integrity Excellent verbal and written communication skills Sound judgment Efficient Self-starter Strong interpersonal communication skills Valid driver's license. Healthcare experience preferred. Experience in front desk, admissions, billing, and/or collections. Excellent verbal and written communication skills. Strong customer service and interpersonal communication skills. Accurate data entry and basic keyboarding skills. Ability to work independently under pressure and handle multiple tasks simultaneously. Ability to enforce fee collection policies. Basic computer/word processing skills. Knowledge and use of typical office equipment (calculator, fax machine, copier, computer, telephone, postage meter, scales, scanner, and computer programs). Knowledge of basic math, accounting, and accounts receivable. Physical Requirements and Working Conditions The physical demands described here are representative of the requirements that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions to the extent such accommodation does not create an undue hardship on the business. Communicate effectively by phone or in person. Vision adequate to read correspondence and computer screens. Prolonged sitting, some bending, stooping, and stretching. Manual dexterity for operating office equipment. Variable workload and periodic high stress. Standard medical office environment. Interaction with patients with various health and legal issues. Extended keyboarding periods. Disclaimer The above statements are intended to describe the general nature and level of work being performed by team members assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of team members so classified. All team members may be required to perform duties outside of their normal responsibilities from time to time, as needed, and this job description may be updated at any time. BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law. Why Join BHG? Work-Life Balance: Enjoy generous paid time off, holidays, and personal needs. Benefit from flexible schedules with early in/early out hours, no nights, and no Sundays. Investment in Your Growth: Prioritize your development with role-based training and advancement opportunities. Comprehensive Benefits: Choose from three benefits programs, including health, life, vision, and dental insurance. Enjoy tuition reimbursement and competitive 401K match. Recognition and Rewards: Experience competitive pay, quarterly bonuses, and incentives for certifications or licenses. Employee Perks: Access exclusive discounts on various services and entertainment options, and benefit from our Employee Assistance Program and self-care series. At BHG, we thrive on the greatness of our people. Join us and become part of a community that values excellence, integrity, and making a real difference in the lives of others. BHG is an equal opportunity, affirmative action employer providing equal employment opportunities to applicants and employees without regard to race, color, religion, age, sex, sexual orientation, gender identity/expression, national origin, protected veteran status, disability status, or any other legally protected basis, in accordance with applicable law. Starting Pay Range: $23-$25/hr Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor.

Back to Search Results Patient Accounts Coordinator Charlotte, NC, United States Shift: Various Job Type: Regular Share: mail

Under direct supervision of the Billing Manager, the Billing Clerk II is responsible for maintaining the clinic billing of all patients, including Medi-cal, Medicare, and third-party billing; and for maintaining an open line of communication with all insurance carriers including follow-up, denials, and appeals; and for maintaining a professional demeanor with all patients to comply with patient confidentiality (HIPPA) as well as other department managers and staff. Duties and Responsibilities Calls insurance companies to verify insurance eligibility coverage. Performs basic mathematical computations. Works with insurance denials and follows up on claims status. Assists patients with problems concerning their accounts. Covers cashier and Financial Screener stations, when needed. Reviews & Analyzes the A/R Aging Report on a regular basis. Reports any incidents or patient complaints to Billing Manager. Performs special billing projects. Commutes from different clinic locations as requested to cover other Billing staff or attend meetings and in-service trainings. Scheduled to work every other Saturday as a Financial Screener/Cashier (8 hour shift and some Holidays). Responsible for following all Agency safety and health standards, regulations, procedures, policies, and practices. Performs other duties as assigned. Requirements Bilingual (English and Spanish). Medical Billing/Coding Certification Two (2) years billing experience in a medical setting. Have the ability to prioritize, organize, trouble shoot and problem solve. Effective verbal and written communication skills. Knowledge in current ICD 9, ICD 10, CPT Codes & HCPCS. Knowledge in Insurance verification & eligibility. Must have reliable transportation

Under the direct supervision of the Billing Manager, the Financial Screener & Cashier are responsible for financially screening and enrolling patients to determine what program offered by Arroyo Vista the patient qualifies for and to review each patient encounter for charge completeness and accuracy of charges. DUTIES AND RESPONSIBILITIES: Responsible to assist patients regarding billing & payment concerns with accounts. Responsible in calling Insurance companies to verify Insurance eligibility. Responsible in collecting payments on bad debt patient accounts and setting up patient payment financial arrangements Responsible in posting payments, charges and adjustments. Responsible to balance all payment collection batches at the end of day, count petty cash each morning, lunch, and evening Responsible in generating reports each morning to post unbilled charges from the previous work day. Responsible to report any incidents or patient complaints to Billing Manager and Billing Lead. Commutes from different clinic locations as requested to cover other Billing staff or attend meetings and in-service trainings. Scheduled to work every other Saturday as a Financial Screener/Cashier (8 hour shift and some Holidays). REQUIREMENTS: Bilingual (English/Spanish). Three (1-2) years billing experience in a medical setting. Ability to work well with others in a team oriented professional manner. Ability to maintain confidentiality and comply with HIPAA regulations. Ability to interact with patients in a professional manner and maintain patient confidentiality. Effective verbal and written communication and interpersonal skills. Knowledge of ICD-10 and CPT and HCPC codes. High School Diploma/GED equivalency.

The Billing Clerk I must be computer literate and have the ability to prioritize, organize, trouble shoot and problem solve. They must have the ability to perform basic mathematical computations. Maintain a professional demeanor with all patients to comply with patient confidentiality (HIPPA) as well as other department managers and staff. DUTIES AND RESPONSIBILITIES: Update pay codes. Interviews patients to determine their pay code. For patients without medical insurance, analyses income and family date to determine eligibility for sliding fee scale. Verifies insurance coverage of patient who claims to have private insurance coverage. Explains to patients or responsible relatives, the Health Center's billing policy and the patient's responsibility for paying their bills. Furnishes patients with appropriate "Patient Responsibility" forms, for signature. Informs billing clerk of any changes in patient's medical chart and the date of the next re-screening. Assists cashier with data entry of charges and payments of visit. Actively participates in the Quality Management Program. Responsible for following all Agency safety and health standards, regulations, procedures, policies, and practices. Performs other duties as assigned. REQUIREMENTS: Must be computer literate and have the ability to prioritize, organize, trouble shoot and problem solve. They must have the ability to perform basic mathematical computations. Maintain a professional demeanor with all patients to comply with patient confidentiality (HIPPA) as well as other department managers and staff. Must be bilingual in English and Spanish with effective verbal and written communication skills preferred. Knowledgeable with current ICD 9, ICD 10, CPT Codes & HCPCS Must have reliable transportation to commute from clinic locations at any given time during the day to cover the floor or attend meeting and in-service trainings. Must be willing to close the Cashier work station every other day until the last patient is seen by the provider. (Floor schedule will be provided 3 weeks in advance). Must work every other Saturday a full 8 hour shift and some Holidays

Specialist-Payment Posting FLSA Status Job Family: PT FINANCE Responsibilities include the daily posting of primary, secondary and private pay payments according to departmental productivity and quality guidelines. Also responsible for the balancing of daily items posted via the departmental batch summary sheet. Also responsible for the resolution of items within the departmental work queues with accurate system utilization and documentation. Performs other duties as assigned. Job Responsibilities Post electronic and manual payments to Epic on a daily basis. Resolves un-posted payment issues in a timely manner. Resolves items in payment posting WQ's according to departmental standards. Completes assigned goals. Specifications Experience Description Minimum Required: 1 years experience in healthcare cash posting or billing. Preferred/Desired:

Summary: The Accounts Receivable Specialist is responsible for payer-specific claim follow up to encourage stable AR metrics and revenue. THIS IS AN OFFICE-BASED ROLE. Essential Duties and Responsibilities Review payer aging reports to identify issues with timeliness, accuracy, and completeness of reimbursement. Identify and resolve claim denial/non-payment patterns. Review patient balances for self-pay collections. Initiate claim appeals where appropriate. Manage rejected and invalid claims. Respond to patient requests regarding billing questions/concerns. Review credit balances for accuracy prior to generating refund requests. Keep abreast of changes in Medicare, Medicaid, and insurance providers regarding pre-certification procedures. Possess working knowledge of CPT codes, ICD10 codes and Medical Terminology. Uphold the CDHA mission by actively contributing to the achievement of organizational goals, supporting leadership, promoting unity and teamwork for the benefit of patients. Demonstrate a commitment to quality of care. Maintain a clear focus on patient safety in every interaction with every patient. Actively participate in workplace improvement to maintain a patient service excellence environment. Adhere to all industry standards related to infection control, patient confidentiality, and regulatory and accrediting body's requirements (i.e. HIPAA, OSHA, and AAAHC). Follow and comply with all safety policies. Additional duties as assigned within the scope of responsibility. Requirements To perform the job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. PLEASE NOTE: THIS ROLE IS BASED IN-OFFICE in CHARLOTTE, NORTH CAROLINA. Education/and or Experience: High School Diploma or GED. Minimum two years in medical billing or hospital coding, as a claims processor, medical claims for an insurance carrier, or clerical/billing experience in a medical office preferred. Knowledge of medical billing software. Must be able to successfully interpret Explanation of Benefits and Electronic Remittance Advice statements. Excellent organizational, problem-solving and critical thinking skills are required. Must be a team player and able to work with various departments throughout the organization. The ability to maintain confidentiality is required. Ability to communicate effectively both verbally and in writing. Participates in performance improvement activities. Is actively committed to meeting or exceeding employee expectations/satisfaction in the performance of job functions. Retains all accreditations, licensures, and designations in good standing. Maintains compliance with all laws and applicable regulatory requirements. Acts promptly to comply with required changes. Salary Description $19 - $22 hourly