by twochickswithasidehustle | Apr 25, 2024 | Uncategorized
Job Description
About Us
Our culture is based on connection, and that fuels our outstanding performance. At BroadPath, we maintain and nourish a commitment to home-based talent and innovative workforce technology that enables us to deliver unrivaled quality, flexibility, and transparency. We believe in meeting our associates where they are, be it in geography or career development. Our proprietary platform visually connects the members of each home-based client team, fully unleashing the skills and motivation of the industry’s best workforce and enabling our associates to reach their full potential. BroadPath is where connection happens.
Today, we provide services to Fortune 10 Health plan companies and Healthcare providers. BroadPath essential business functions include customer experience, sales, and back-office operations.
Overview
Broadpath is immediately hiring for a Claims Processor to join our team. Our Claims Processor will be responsible for accurately and timely entering, reviewing, and resolving simple to moderate-complexity claims according to the guidelines, procedures, and policies.
Responsibilities
Conduct thorough reviews of claim denials and incorrect payments, with a focus on identifying opportunities for appeal. This involves utilizing various guidelines and reference tools such as CPT, ICD-9, ICD-10, HCPCS, medical terminology manuals, Correct Coding Initiative Edits, Medicare Fee Schedule, and modifier rules.
Demonstrate proficiency in investigating rules and processes related to claims where necessary, ensuring adherence to industry standards and regulations.
Ability to process both clean and unclean claims efficiently, maintaining accuracy and compliance with payer requirements.
Utilize electronic claim editing systems to verify the accuracy and completeness of all necessary information before submission to payers.
Post insurance and patient payments accurately, applying correct denial codes to facilitate proper account management.
Engage with physician offices to gather additional information required to address claim edits or pursue appeals for denied claims.
Effectively manage and resolve correspondence from insurance companies and patients, demonstrating strong communication skills.
Retrieve all necessary information to assess the validity of refund requests and take appropriate action.
Participate in the mailing process of patient statements, ensuring timely and accurate communication with patients regarding their accounts.
Qualifications
Proficiency in handling daily computer operations with ease, showcasing strong technical skills.
Previous experience in navigating health insurance claims processes, preferably on either the payer or provider side.
Solid understanding of medical and insurance billing practices, demonstrating knowledge in this area.
Exceptional communication abilities coupled with outstanding customer service skills.
Adeptness in identifying the root causes of unpaid claims or patient accounts and devising efficient communication strategies and methods for appeals, along with providing accurate documentation for resolution.
Familiarity with payer and governmental regulations governing the revenue cycle process, ensuring compliance with rules and regulations.
Effective communication skills for liaising with physicians and practice staff to gather additional information for resolving edits and unpaid claims.
Ability to engage with patients, effectively communicating about their accounts and addressing any queries or concerns they may have.
Systems Experience Required:
IDC 10 Code knowledge is required. ( ICD Code 9 knowledge is also acceptable)
Preferred Qualification:
1-2 years of claims processing experience
Experience in Adjustments, Adjudication, and Provider Dispute Resolution ( PDR) is highly valued as it showcases a deep understanding of the claims process.
Epic Tapestry is highly preferred.
Diversity Statement
At BroadPath, diversity is our strength. We embrace individuals from all backgrounds, experiences, and perspectives. We foster an inclusive environment where everyone feels valued and empowered. Join us and be part of a team that celebrates diversity and drives innovation!
Equal Employment Opportunity/Disability/Veterans
If you need accommodation due to a disability, please email us at [email protected]. This information will be held in confidence and used only to determine an appropriate accommodation for the application process
BroadPath is an Equal Opportunity Employer. We do not discriminate against our applicants because of race, color, religion, sex (including gender identity, sexual orientation, and pregnancy), national origin, age, disability, veteran status, genetic information, or any other status protected by applicable law.
Compensation: BroadPath has an effective process for assessing market data and establishing ranges to ensure we remain competitive. You are paid within the salary range based on your experience and market data of the position. The actual salary for this role may vary by location.
APPLY
by twochickswithasidehustle | Apr 25, 2024 | Uncategorized
Posting Details
Posted: April 23, 2024
Full-Time
LocationsShowing 1 location
Remote USA
United States
Job Details
Description
Effectively Coordinate with all of our satellite labs with regards to the following:
Effectively coordinate with Laboratory Managers and Facility Managers for build-out of new labs.
Ensure Local lab manager and lab director have proper & current Policies and Procedures
Coordinate and conducts the LIS testing with all our satellite labs and Burbank Lab with I.T. department
Assist in researching the Federal and State requirements of our out of state labs and in the submission of applications of permits and licenses of all our labs.
Coordinate with different departments (data entry, liaison, specimen receiving, scanning, dispatch, stat trackers, laboratory) to create training and operating manual for all departments related to laboratory operations.
Occurrence Reports – Prompt process of the daily internal occurrence reports which
Review the reports and supporting documents and add any missing documents or information important for the investigation.
Investigate to find the root cause of problems and errors. Check the accuracy of the internal occurrence report.
Forward the internal occurrence report to the involved department supervisor(s) for further investigation and corrective action.
Review the corrective action documents submitted if complete and accurate.
Writes external occurrence reports if needed in a timely manner.
Tracks the 90 day re-assessment of employees if applicable.
Generates the monthly summary of occurrence reports.
Maintains accurately the occurrence report database.
CAP Proficiency Test – Responsible for tracking of Proficiency Test survey orders from arrival in the laboratory to resulting of the tests.
Follow the CAP PT Tracking Procedures
Making sure that all PT surveys ordered arrive on the set scheduled delivery date.
Making sure that all PT survey results are faxed before their due date.
Knowledge on how to log PT specimens (i.e. assigning of accession numbers)
Accurately entering in the orders in our LIS (LC.EPP)
Making sure that results are entered into our LIS.
Proper endorsing of the PT specimens and documents to the Lead CLS
Faxing of PT results to CAP
Updating the PT survey database with all the pertinent information in real time.
Ordering of CAP PT survey specimens
Communicating through email the arrival and due dates of PT surveys which includes other information needed.(i.e specimen numbers, CLS assigned, etc.)
Tracking of the PT scores received.
includes but not limited to:
CLS California Dept. of Public Health License, Nevada Lab Tech and Lab Assistant state license filing and tracking.
Ensures that all original or official duplicates of phleb and CLS licenses are on file and current.
Lab License, CLIA, CAP, Medical Waste Permit applications / renewals submission and other licenses or permits required.
Completes all the paperwork needed for the lab license, CLIA and CAP certificates applications/renewals for all DL Labs.
Lab Audits – Conducts lab internal audits/inspections to measure and adhere to state required regulations.
Ensures that corrective action is done if necessary.
Ensures that the lab audits are documented.
Works with Lab Leadership in preparing the laboratory to be inspection ready by the State, CLIA and CAP.
Conducts research, compile data, prepares reports, recommendations or alternatives that address existing and potential problems.
Must learn and be proficient in the laboratory LIS/CRT programs used by other depts.
Must learn the procedure and operations of other departments.
Writes and implements appropriate policies and procedures.
Maintain and organize company documents not limited to policies and procedures, training, competency testing, legal documents and other documents as required.
Maintain strict confidentiality in all aspects of the client, employee and laboratory records and documents.
Assist the Laboratory Director, Lab Manager, Technical Supervisors, Lead CLS, VP of Laboratory Services, Quality Assurance Admin. Manager to be in compliance with the state and federal regulations.
Filing and keeping of records up to date and in an organized manner.
Train other departments of policies and procedures as needed.
Should be able to investigate client complaints and make appropriate corrective actions. Ensures client issues/ or concerns are identified, investigated and resolved.
Assists the QA admin. manager in maintaining quality standards of the laboratory and to facilitate the operations of the QA dept.
Performs other duties as required.
Review incoming phone calls, mail, emails, etc.
Performs general office maintenance duties and other duties as required
KNOWLEDGE AND SKILL REQUIREMENTS:
High School graduate or equivalent.
Minimum of 2 years experience working in a clinical laboratory.
Advanced computer skills / knowledge of computer programs (MS Office, Adobe Acrobat professional)
Ability to work independently and as part of a team and have a good sound analytical judgement and problem solving skills.
Attentive to details and accuracy.
Must have the ability to learn quickly, prioritize and execute multiple tasks in a high pressure environment.
Proficient in written skills in the English language.
Ability to work under pressure and meet expected deadlines.
Ability to work in a fast paced environment.
Ability to maintain effective working relationship with co-workers, clients and vendors.
Must be able to conduct business in a professional and manner.
by twochickswithasidehustle | Apr 25, 2024 | Uncategorized
Description
Kforce has a client seeking a Data Entry Specialist. This is a remote role but requires candidates to work PST hours. In this role, the Data Entry Specialist will perform manual review of data to deduplicate rows and pair them to their CRM records.
Requirements
1+ years of Data Entry experience
Google Sheets or Excel experience
The pay range is the lowest to highest compensation we reasonably in good faith believe we would pay at posting for this role. We may ultimately pay more or less than this range. Employee pay is based on factors like relevant education, qualifications, certifications, experience, skills, seniority, location, performance, union contract and business needs. This range may be modified in the future.
We offer comprehensive benefits including medical/dental/vision insurance, HSA, FSA, 401(k), and life, disability & ADD insurance to eligible employees. Salaried personnel receive paid time off. Hourly employees are not eligible for paid time off unless required by law. Hourly employees on a Service Contract Act project are eligible for paid sick leave.
Note: Pay is not considered compensation until it is earned, vested and determinable. The amount and availability of any compensation remains in Kforce’s sole discretion unless and until paid and may be modified in its discretion consistent with the law.
This job is not eligible for bonuses, incentives or commissions.
Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.
by twochickswithasidehustle | Apr 25, 2024 | Uncategorized
Remote
Revenue Cycle Medical Records Case Manager
Job Description Summary
The Revenue Cycle Medical Records Case Manager will support documentation of medical necessity by facilitating medical records (MR) collection and client outreach, by offering expert review and interpretation on a case by case basis, and by maintaining collaborative and productive relationships within the organization relating to Revenue Cycle Management.
Job Responsibilities:
Successfully obtain necessary medical documentation by collaborating with and serving as a primary liaison between in-house billing operations, customer experience groups and clinic medical records departments
Have a thorough understanding and knowledge of applicable CMS, state, and insurer medical policy and coverage guidelines (in particular LCD & NCD Coverage Criteria)
Ability to navigate and extract data from multiple versions of electronic medical records, including EPIC
Serve as a source of knowledge for medical records (MR) review and interpretation, including in-depth review of provider progress notes and charts with the ability to identify critical data points highlighting why patient criteria meets medical necessity and summarizing in a succinct manner for health insurance companies
An in-depth knowledge and understanding of oncology and organ health terminology (including chemotherapy treatments and well as immunotherapy treatments)
Develop and cultivate ongoing working relationships with other departments impacting revenue cycle performance
Participate in weekly meetings, daily discussions, case reviews and continuing education to review key metrics, workflows, trends, and performance improvement opportunities
Prioritize performance initiatives and ensure productivity goals are achieved within a timely manner while maintaining the highest quality of work standards for Q/A
Follow department procedures and ensure all activities are documented and conducted within compliance standards with applicable business process requirements and regulatory requirements
This role requires access to Patient Health Information (PHI) both in paper and electronic form. Therefore, employees must complete training relating to HIPAA & PHI privacy, General Policies and Procedure Compliance training and security training as a requirement of the job
Qualifications:
At least 3 years of relevant experience, including but not limited to: health care administration, case management, nursing, oncology/transplant clinic, medical billing/coding, appeals and denials management and/or insurance collections
Bachelor’s Degree (BS, LPN, RN, BSN, BSHA)
Healthcare related field of study or equivalent experience (Clinical Case Managers)
Required Knowledge, Skills and Abilities:
Knowledge of medical billing systems, medical terminology and abbreviations, basic procedure coding knowledge and health care nomenclature and systems
Proficiency with G-Suite products, including Google Calendar and G-Sheets, and strong analytic skills with ability to interpret, evaluate and act on clinical information
Previous experience working in an Oncology or Transplant clinical setting strongly preferred
Excellent organizational, time management and problem solving skills
Excellent interpersonal skills as well as the ability to work with a variety of internal and external colleagues from all levels of an organization
Ability to work in a high performing, fast paced team environment that requires flexibility
Ability to navigate across multiple customer demands and balance competing priorities successfully
Ability to analyze, identify and articulate/report trends succinctly in a clear and concise manner
Ability to solve problems using critical thinking skills
Maintains confidentiality of sensitive PHI information
The pay range is listed and actual compensation packages are based on a wide array of factors unique to each candidate, including but not limited to skill set, years & depth of experience, certifications and specific office location. This may differ in other locations due to cost of labor considerations.
Remote USA
$27—$31 USD
by twochickswithasidehustle | Apr 25, 2024 | Uncategorized
Release of Information Specialist (ROIS)
Summary of Position:
The Release of Information Specialist (ROIS) initiates the medical record release process by inputting data into Verisma Software. The ROIS works quickly and carefully to ensure documentation is processed accurately and efficiently. This position is remote. The primary supervisor is Manager of Operations, Release of Information.
Duties & Responsibilities:
Process medical ROI requests in a timely and efficient manner
Process requests utilizing Verisma software applications
Support the resolution of HIPAA-related release issues
Organize records and documents to complete the ROI process
Read and interpret medical records, forms, and authorizations
Provide exemplary customer service in person, on the phone and via email, depending on location requirements
Interact with customers and co-workers in a professional and friendly manner
Utilize reference material provided by Verisma to ensure compliance and confidentiality is always maintained
Attend training sessions, as required
Live by and promote Verisma company values
Perform other related duties, as assigned, to ensure effective operation of the department and the Company
Minimum Qualifications:
HS Diploma or equivalent, some college preferred
RHIT certification, preferred
2+ years of medical record experience
2+ years of experience completing clerical or office work
Experience using general office equipment including desktop computer, scanner, Microsoft Office Suite to complete tasks
Experience in a healthcare setting, preferred
Knowledge of HIPAA and state regulations related to the release of Protected Health Information, preferred
Must be able to work independently
Must be detail oriented
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