OCHIN is a rapidly growing national nonprofit health IT organization with two decades of experience transforming health care delivery to drive health equity. We are hiring for a number of new positions to meet increasing demand. When you choose to join OCHIN, you have the opportunity to continuously grow your skills and do meaningful work to help fulfill our mission.
OCHIN provides leading-edge technology, data analytics, research, and support services to more than 500 community health care sites, reaching nearly 6 million patients nationally. We believe that every individual, no matter their race, ethnicity, background, or zip code, should have fair opportunity to achieve their full health potential. Our work addresses differences in health that are systemic, avoidable, and unjust. We partner, learn, innovate, and advocate, in order to close the gap in health for individuals and communities negatively impacted by racism or other structural inequities.
At OCHIN, we value the unique perspectives and experiences of every individual and work hard to maintain a culture of belonging.
Founded in Oregon in 2000, OCHIN employs a growing virtual workforce of more than 500 diverse professionals, working remotely across 40+ states. We offer a generous compensation package and are committed to supporting our employees’ entire well-being by fostering a healthy work-life balance and equitable opportunity for professional advancement. We are curious, collaborative learners who strive to live our values everyday: leadership, collaboration, excellence, innovation, inclusion, and stewardship. OCHIN is excited to support our continued national expansion and the increasing demand for our innovative tools and services by welcoming new talent to our growing team.
Position Overview
The Medical and Dental Billing Specialist supports the mission of OCHIN by providing high quality billing services to one of more OCHIN Billing Services (OBS) member clinics. The Billing Specialist will primarily focus on payor follow-up and denial management, recognize potential high-risk accounts, and develop techniques to improve collections and streamline processes. The OBS team member will discuss difficult or unique collection problems with the Billing Supervisor, resolve issues, apply new information to future collection issues, and make suggestions to enhance our efficiency and effectiveness through process improvement with the assistance of their immediate supervisor. This position will enhance the billing department’s reputation by accepting ownership for accomplishing new and different requests and exploring opportunities to add value to job accomplishments.
COVID-19 Vaccination Requirement
To keep our colleagues, members, and communities safe, OCHIN requires all employees—including remote employees, contractors, interns, and new hires—to be vaccinated with a COVID-19 vaccine, as supported by state and federal public health officials, as a condition of employment. All new hires are required to provide proof of full vaccination or receive approval for a medical or religious exemption before their hire date.
Essential Duties
Medical Billing
Provide efficient and effective account receivable services on behalf of our member clients to maximize their reimbursement and support OCHIN revenue cycle performance indicators for financial health
Accurately bill Medicare, Medicaid, self-pay/uninsured, and commercial insurance, processing claims in accordance with payer requirements and organization policy
Assist with the collection of receivables by monitoring accounts receivables, checking claim status and resubmitting claims of overdue accounts, filing corrected claims or appeals and alerting supervisor of seriously overdue accounts and trends
Post patient payments, electronic remits, and paper explanation of benefits (EOBs).
Correct claim and charge errors
Thoroughly research and resolve credit balances
Answer phone calls from patients and responsible parties regarding account balances and/or other matters. Provide compassionate and empathetic customer service
Perform other specific projects related to billing, data entry, and computer operations as required
Account Maintenance
Perform registration updates in Epic
Maintain complete and accurate billing and accounts receivable records
Send correspondence to member clinic/Client in accordance with their policies and procedures
Additional Responsibilities
Establish and maintain positive working relationships with patients, payers, team members, clients, and other stakeholders. Maintain confidentiality of patient information, organization data and information always in compliance with HIPAA regulations
Continuously improve understanding of collection processes and strategies by working with colleagues within OBS and OCHIN Collaborative. Other duties as assigned
Qualifications
1 year of progressive experience in similar or relevant role preferred. 2 years of applicable experience desired
Minimum of a high school diploma or GED is required. Some higher education is preferred
Previous FQHC/RHC experience preferred
Knowledge of Medical Terminology is preferred in this role
Working knowledge of Medicare, Medicaid, MVA, Workers Comp and private insurance billing and reimbursement processes, legal requirements knowledge
Bilingual Preferred (English/Spanish)
Dual language differential of 10% of base rate for intermediate to advanced in skills to speak, write and read dual languages, regardless of what language.
Desired Certifications include:
Medical coding from AAPC (CPC Certificate)
AHIMA (CCS Certificate)
Current certification from ADCA (CDC certificate)
HFMA (CRCR certificate)
Experience using EPIC practice management system, strongly preferred
The Fundworks, LLC is a provider of alternative financing to small businesses and merchants, focusing on both healthy and challenged companies. We ourselves are a team of entrepreneurs who have spent our careers growing small entrepreneur and family-owned companies. We are looking for the right individual to join our team, who is ready to learn and use their skills and experience to add value to our ever-growing company.
Job Summary
Our Data Entry Clerk is processing and analyzing daily incoming submissions from our external customers. The clerk is responsible for accurately and efficiently inputting all information provided on the documents into our internal servers, and pulling various reports related to the submissions.
Responsibilities and Duties
Ensure all required documents are submitted
Create entries in our internal systems accurately inputting business and owner information
Pull and review commercial and consumer credit reports
Process 100+ submissions a day
Communicate effectively throughout the analysis review
Provide high quality customer service to internal and external clients
Occasionally perform other duties as assigned by management
Skills and Competencies
Highly detail-oriented and comfortable dealing with numbers
Excellent organizational skills and ability to prioritize workload in order to meet tight deadlines in a fast-paced and dynamic work environment
Strong verbal and written communication skills
Resourceful – willing to take on other assignments as needed to support the team
Qualifications
1 – 3 years of previous financial services underwriting or processing experience is preferred
Compensation
$16 – $18/hour, based on experience
Benefits and Perks
We offer competitive medical, dental, vision and basic life benefits, 401K, performance bonus, paid time off, sick days and paid holidays.
Remote work available in CA, NJ, NY, MO, MA, TX, UT, PA
Ready for a career that excites you and has you up early, beating the alarm clock in the morning?
Joining ExamWorks as a Claims Analyst may be the best decision you ever make.
You will be responsible for determining the reasonable cost of medical care and manually reviews for application of proper fee schedule, accurate diagnosis and ICD/CPT coding, and duplicate billing in addition to other factors.
This position is 100% remote. Candidate must beavailable to work 8:00a-5:00p PST; Monday through Friday. Office equipment (office phone, screen, keyboard, mouse and virtual desktop) will be provided.
We’ve got an awesome team already, but there’s always room for more! Join us and discover how you can shape your own future at ExamWorks.
Responsibilities
Processes claims by correctly identifying the billing type (physician, surgery center, hospital, etc) and entering medical bills into the reviewing system, allowing automated adjudication to process.
Receives client submissions and inputs client and examinee data in the system database.
Reviews each claim and addresses all necessary modifications manually.
Ensures all medical records and reports are properly documented and saved in the appropriate location and available for audit at all times.
Processes client invoicing in accordance with the client’s fee schedule.
Qualifications
High school diploma or equivalent required.
Experience in a medical office or insurance industry with knowledge of standard fee schedule review, UC&R review, drug and supply charges, rarity, utilization review, CPT guidelines, ICD-9 coding, bundling/unbundling and duplicate billing.
CPC Certified preferred.
Must have moderate to high level of computer and multiple software programs competency, including but not limited to Microsoft Word, Outlook, Excel, and the Internet.
Must have a full understanding of claim adjudication for First & Third Party, Med Pay, No-Fault, Group Health, Workers Compensation, hospital claims and PPO.
Must have full understanding of the various types of medical billings and ability to identify which system database should be used.
Must be able to cross reference different types of billings to ensure consistency in the review process.
ExamWorks is a leading provider of innovative healthcare services including independent medical examinations, peer reviews, bill reviews, Medicare compliance, case management, record retrieval, document management and related services. Our clients include property and casualty insurance carriers, law firms, third-party claim administrators and government agencies that use independent services to confirm the veracity of claims by sick or injured individuals under automotive, disability, liability and workers’ compensation insurance coverages.
ExamWorks offers a fast-paced team atmosphere with competitive benefits, paid time off, and 401k.
WHAT YOU’LL DO:Monitor, review and/or evaluate the quality of service provided by department staff to measure service quality and identify non-conformance while maintaining production and time service goals. On a regular basis, provide regular coaching and feedback to individual staff. May schedule staff to assure adequate/required service level coverage for customers.May review and/or handle appeals and/or elevated issues as appropriate.May validate accuracy of decisions/processes for adherence to set standards and/or applicable regulations or requirements. May work with external parties for resolution.May prepare reports of quality results for use by management in evaluating performance or developing training.May perform standard premium and eligibility processing functions.Maintains confidentiality in the collection, maintenance and dissemination of restricted, sensitive or other information as identified by management.Establishes and maintains effective working relationships with personnel at all levels of the Company to assure the successful implementation and delivery of programs.May determine and recommend billing and enrollment alternatives to support non-standard requests to establish processes and systems. This job posting is reflective of the Quality Audit Representative essential functions, qualifications, and physical requirements. The Sr Quality Audit Rep level has variable essential functions, qualifications and physical requirements. Competency and skill set will determine level of placement within the posted job family.
ABOUT YOU:You help promote a culture of diversity and inclusion within the department and the larger organization. You value different ideas and opinions. You listen courageously and remain curious in all that you do.You are able to work remotely and have access to high-speed internet.Strong Customer Service skills and ability to work effectively with others through effective verbal and written communication.Strong teamwork, collaboration and flexibility.Thorough knowledge of one or more of the Company’s product lines.Strong analytical ability, sound judgment and math aptitude.Thorough knowledge of applicable laws and regulationsAbility to work well under pressure and deadlinesProficient with personal computer and software applications/data entryMicrosoft Word and ExcelGood oral and written communication skills and the ability to effectively articulate instructions and information to other associatesSome knowledge/skill in presentation
VALUABLE EXPERIENCE:Experience with Compass system and GSAP (Group Sales Application)EDI experience Knowledge of eligibility rules.Strong knowledge of Group Insurance.
WHAT WE CAN OFFER YOU:Salary Range: Minimum: $19.50 – $27.00/hourPay commensurate with experience.
At Zotec Partners, our People make it happen. Transforming the healthcare industry isn’t easy. But when you build a team like the one we have, that goal can become a reality. Our accomplishments can’t happen without our extraordinary people – those across the country who make up our diverse Zotec family and help make this company a best place to work. Over 20 years ago, we started Zotec with a clear vision, to partner with physicians to simplify the business of healthcare. Today we are more than 1,000 employees strong and we continue to use our incredible talent and energy to bring that vision to life. We are a team of Innovators, Collaborators and Doers. We’re seeking a Payment Posting Specialist to join us. As a Payment Posting Specialist, you will be responsible for researching payment posting issues and making sure that payments are applied to the patient’s accounts in a timely and accurate manner. This position will require effective communication with Banks, Clients, Attorneys and Insurance Carriers to resolve posting issues.
What you’ll bring to Zotec:
Understanding of Explanation of Benefits (EOBs)
Knowledge of payment processes from insurance carriers, patients, and HSAs
Ability to work within deadlines and in high volume conditions
Proficient in Microsoft Word, Excel and Adobe Acrobat products
Ability to multi-task and deal with change constructively
Ability to follow through, identify road blocks and provide resolution scenarios
Must be detail oriented, be able to work independently, and manage multiple projects
Proficient in maneuvering in Insurance Carrier websites
Excellent verbal and written communication skills required
Pleasant phone manner when communicating with outside resources
Medical billing office and payment posting knowledge is preferred
High School Diploma or equivalent required
We are passionate about empowering our employees to be extraordinary – and they continue to come through. So, if you are an Innovator, Collaborator and Doer, then welcome home.
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