by Irma Moore | Mar 13, 2024 | Uncategorized
Summary/Objective
Responsible for verifying patient’s eligibility and benefits. Provides support to Centralized Services Department under the direction of Centralized Services Supervisor. Performs administrative tasks such as obtaining and verifying eligibility and benefits, while applying critical thinking skills to investigate patient information discrepancies to resolve problems.
Essential Functions
- Initiates benefit verification for patients.
- Contacts various insurance carriers via phone and website/portals to obtain verification of eligibility.
- Provides accurate time of service estimates for patient procedures.
- Verifies data entry accuracy.
- Identifies patient information inaccuracies and investigates to resolve issues and correct information.
- Prioritizes patients as outlined in department workflow policy.
- Other duties as assigned.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Competencies
- Customer Client Focus
- Problem Solving/Analysis
- Technical Capacity
- Time Management
- Communication Proficiency
- Teamwork
Supervisory Responsibility
This position has no supervision responsibilities.
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
by Irma Moore | Mar 13, 2024 | Uncategorized
Position Summary
-Under general supervision, verifies enrollment status, makes changes to member/client records, and addresses a variety of enrollment questions or concerns.
– Maintains enrollment databases and coordinates transfer of non-electronic eligibility data.
– Responds, researches, and resolves eligibility and/or billing related issues involving member specific information; Works directly with clients, field marketing offices and/or local claim operations to achieve positive service outcomes.
– Monitors daily status reports assessing output for developing trends potentially impacting service levels.
– Applies all appropriate considerations associated with technical requirements, legislative/regulatory policies, account structure and benefit parameters in addressing eligibility matters.
– Validates benefit plan enrollment information for assigned clients for accuracy and completeness; coordinates the distribution of membership ID cards and partnering with appropriate internal/external support areas involving any requests for ID card customization.
– Completes screen coding and data entry requirements related to the systems processes impacting the generation and release of member-specific and plan sponsor products (e.g., ID cards, change applications, audit lists, in-force lists, HIPAA certificates and various reports).
– Completes data entry requirements for finalizing new enrollment information as well as for changes and/or terminations.
– When necessary, reviews and corrects transaction errors impacting eligibility interfaces and prepares eligibility/enrollment information for imaging.
– Interprets and translates client benefits and supporting account structure against internal systems/applications
– Determines and communicates standard service charges to internal/external customers related to paper eligibility activities; May include negotiating and communicating charges pertaining to non-standard services.
– Partners with other team functions to coordinate the release of eligibility and benefit plan information; reproduces group bills if requested by clients.
Required Qualifications
– 1-3 years strong data entry skills
– 1-3 years Microsoft Suite
– 1-3 years customer service
by Irma Moore | Mar 13, 2024 | Uncategorized
Job Description
HR Admin Assistant
Contract
Location: Remote or Boston, MA 02215
Must Haves:
- Associate’s degree or BS degree in progress
- Administrative skills
- Data entry/data management skills
Preferred:
Job Summary/Description: an esteemed higher education institution is looking for some support in their HR department with a short-term project. This individual will use their keen eye for detail and desire to grow in HR to assist with the organization and management of resumes in the University database. Responsibilities will include:
- Uploading resumes into University database
- Searching for existing resumes
- Pulling resumes from the data base
by Irma Moore | Mar 13, 2024 | Uncategorized
Major Responsibilities:
- Reviews medical documentation at a proficient level from clinicians, qualified health professionals and hospitals in order to assign diagnosis and procedure codes utilizing ICD-10 CM/PCS, CPT, and HCPCS. Assigns and ensures correct code selection following Official Coding Guidelines and compliance with federal and insurance regulations an EMR and/or Computer Assisted Coding software.
- Adheres to the organization and departmental guidelines, policies and protocols.
- Reviews all clinician documentation to support assigned codes in the health information record so that all significant diagnoses and procedures may be captured for reimbursement and data purposes.
- Conduct independent research to promote knowledge of coding guidelines, regulatory policies and trends.
- Abides by the Standards of Ethical Coding as set forth by the American Health Information Management Association and adheres to official coding guidelines. Practices ethical judgment in assigning and sequencing codes for proper insurance reimbursement.
- Maintains the confidentiality of patient records. Reports any perceived non-compliant practices to the coding leader or compliance officer.
- Meets then exceeds departmental quality and productivity standards.
- Recommend modifications to current policies and procedures as needed to coincide with government regulations.
- Responsible for processing Coding Claim Denials and Coding Claim Rejections, when applicable
Licensure, Registration, and/or Certification Required:
- Coding Certification issued by one of the following certifying bodies: American Academy of Coders (AAPC), or American Health Information Management Association (AHIMA)
Education Required:
- Advanced training beyond High School in Medical Coding or related field (or equivalent knowledge)
Experience Required:
- Typically requires 3 years of experience in professional coding that includes experiences in either hospital or professional revenue cycle processes and health information workflows.
Knowledge, Skills & Abilities Required:
- Advanced knowledge of ICD, CPT and HCPCS coding guidelines. Advanced knowledge of medical terminology, anatomy and physiology.
- Intermediate computer skills including the use of Microsoft office products, electronic mail, including exposure or experience with electronic coding systems or applications.
- Advanced communication (oral and written) and interpersonal skills.
- Advanced organization, prioritization, and reading comprehension skills.
- Advanced analytical skills, with a high attention to detail.
- Ability to work independently and exercise independent judgment and decision making.
- Ability to meet deadlines while working in a fast-paced environment.
- Ability to take initiative and work collaboratively with others.
by Irma Moore | Mar 13, 2024 | Uncategorized
HealthMark Group is growing and looking for bright, energetic, and motivated candidates to join our team. This is an entry level position and an exciting opportunity for someone looking to start their career with a fast-growing company.
LOCATION:REMOTE
Position: QUALITY CONTROL
Job Description:
Entry level job duties include but not limited to:
- Entering data into database software and checking to ensure the accuracy of the data that has been inputted.
- Resolving discrepancies in information and obtaining further information for incomplete documents.
- Reports directly to Quality Control Lead/Manager
- Completes Data Entry of all requests
- Records any relevant notes on specific requests for further/proper handling throughout the request life cycle
- Identify and accurately classify each request
- Uphold HealthMark Group’s values by following our C.R.A.F.T.
- Work quickly to meet the high-volume demand
Requirements:
- 40 wpm
- High Internet speed quality
- Goal oriented, focused on ensuring accuracy and speed
- Computer literacy and familiarity with various computer programs such as
- Attention to detail
- Knowledge of grammar and punctuation
- Ability to work to time constraints
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