"Alerted.org

To facilitate accurate Professional Provider credentialing, coding, billing, posting, and collection for ProMedica Physicians and all other supported entities.

ACCOUNTABILITIES

*All duties listed below are essential unless noted otherwise*

1. Accurate and timely credentialing follow up for all supported providers with hospital privileges, payor/plan credentialing, certifications, and regulations.

2. Acts as a liaison between providers/office staff and hospitals or payor plans.

3. Accurately maintains provider information in credentialing software.

4. Accurately reviews and assigns coding for professional services, including diagnosis, modifier, and procedure codes, as well as additional payor requirements.

5. Accurately and timely input of billing information into the practice management system for payment.

6. Accurately reviews and updates demographic and insurance information in the practice management system.

7. Perform a variety of registration, billing, follow up and collection functions for all payers including self-pay.

8. Verify insurance benefits, limits, and patient obligations.

9. Contact patients for necessary information pertaining to registration, billing, and collection.

10. Process financial assistance applications.

11. Post payments ,adjustments and denials to patient accounts.

12. Review accounts for outside collection or legal authorization.

13. Works with internal departments to obtain information for external requests including refunds.

14. Reviews debits, credits, refunds, bad debt and contractual allowances for accuracy and processes as applicable.

15. Knows and follows all billing regulations and corporate compliance plans.

16. Provide feedback to management on issues that impede timeliness or quality of billing and work with management to resolve.

17. Maintains current payor knowledge for effective claims management and follow up of unresolved claims.

18. Routinely reviews workflows for process improvement and efficiencies and provides feedback to management for implementation of changes.

19. Independently reviews assigned workloads and completion to ensure goals are being met.

20. Acts as a resource for staff.

21. Assist management with training new staff.

22. Perform other duties as assigned.

Education: Must have a high school diploma or equivalent.

Skills: Must demonstrate the ability to accurately and independently solve problems by passing a basic skills test. Must demonstrate excellent communication and interpersonal skills and show

commitment to exceptional customer service. Must have previous experience with computers and office equipment, as well as be able to input and retrieve information from a computer, operate a calculator, fax machine and copier. Must have the ability to manage large volumes of work, ability to quickly learn and retain information regarding issues that present themselves.

If applicable to position must have the following:

• Experience reading hospital/Physician medical records

• Detailed understanding of CPT & ICD-9 (10) coding

• Detailed understanding of Professional charging processes

• Experience with follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, and rebilling, and denied claims for accounts that are greater than 30 days old.

• Experience completing hospital and payor credentialing forms

Years of Experience: Must have at least 3 years’ experience in Professional/Physician credentialing, billing, collection with at least 2 years’ experience specific to credentialing and/or billing office work.

WORKING CONDITIONS

Physical Demands: Must be able to move about office and between workstations and occasionally lift, move, and carry moderately heavy materials.

We offer a competitive benefits package with coverage effective day one of employment which includes medical, dental, vision, company paid life insurance, paid time off, a 401k retirement plan, an employee assistance program and other voluntary coverage options and employee discounts.

Pay Range: $32,240-$55,120

The above list of accountabilities is intended to describe the general nature and level of work performed by the incumbent; it should not be considered exhaustive.

ProMedica is a mission-based, not-for-profit integrated healthcare organizational headquartered in Toledo, Ohio. For more information, please visit www.promedica.org/about-promedica

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact [email protected]

Equal Opportunity Employer/Drug-Free Workplace

**Requisition ID:** 92944