Overview:
Grow your career! At EmpowerMe Wellness, you’ll find opportunities for promotion, continuing education, and great benefits, all while making a real difference in the life of seniors. Our results are in our success stories – come write yours with us. Join our team today!
Who We Are
EmpowerMe Wellness – is on a mission to improve the lives of seniors and the communities they call home! We provide fully integrated on-site therapy, pharmacy services, primary care, and more at senior living communities nationwide. Our experienced team of more than 3,000 clinicians and professionals provide personalized health and wellness solutions for seniors in more than 35 states. To learn more about us, visit empowerme.com.
Responsibilities:
- Provide outcome data to revenue cycle leaders and team members with initial review and summary
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Provide analysis concerning process improvement, claim denial reduction, and improved payment collection .
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Assist in developing and calculating key performance indicators as they relate to the performance of the accounts receivable team.
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Completes accounts receivable insurance collections and follow-up on claims to expedite payment from assigned insurance companies.
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Contacts insurance companies regarding claims, updates account information, and completes basic administrative tasks on accounts.
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Communicates claim issues concerning patient benefits to the verification specialists.
Proactively interacts with representatives of third-party payers to improve communication, resolve claims processing issues and discuss changes in plan requirements. -
Recommends policies and procedures to ensure effective and efficient operation of third-party carriers and informs the Billing Supervisor of issues related to third-party carriers.
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Remains current in new developments nationally and locally in third-party payment policies, practices and procedures.
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Assists and prepares monthly reports to include key indicators, payer issues and unit performance.
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Process appeals by gathering information and resubmitting claims with timely follow up on status.
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Other duties as assigned by the Vice President of Reimbursement.
Qualifications:
- Bachelor’s degree or Associate’s degree plus 3 year of professional office experience, or High School diploma or GED plus 5 years professional office experience (professional office experience in healthcare setting is preferred).
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Must exhibit a very high level of thoroughness & detail orientation.
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Goal- and result-oriented, as well as self-motivated with a sense of professional curiosity, desire to learn new things, and to find / recommend solutions to problems.
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Excellent communication and interpersonal skills required.
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Must have the ability to work in a fast-paced environment, remain calm in stressful situations, to be flexible, to work well with many interruptions and have skill in multi-tasking.
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Must exhibit and promote a high level of customer service, hospitality, curiosity and friendliness towards all clients, visitors, coworkers.
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Quickly adapts to change and takes a proactive approach to problem solving.
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Knowledge and understanding of HIPAA and CMS guidelines.
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Ability to analyze, interpret and draw inferences from research findings and prepare reports.
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Knowledge of and experience with insurance benefit coordination, medical credentialing and medical billing.
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Working knowledge of clinical and/or Agency operations and procedures.
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Ability to use independent judgment to manage and impart confidential information.
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Database management skills including querying, reporting, and document generation.