<h3>Job Description</h3>
Premier Medical Resources is seeking to hire a Workers Compensation Denial Specialist is responsible for performing insurance appeals of denied and underpaid accounts. 
This would include reviewing payer websites and performing phone calls for appealed, denied or underpaid claims to secure payment for services rendered by the provider.
ESSENTIAL FUNCTIONS: • Responsible for managing, monitoring, and collecting payments on accounts from all WC Third-Party Payers • Reporting of denial trends and payer policy updates to management. • Work with Supervisor/Manager to identify denial/payment trends and create solutions to decrease future denials • Maintain understanding of payer contracts, claims filing deadlines and fee schedules • Works with WC insurance providers to resolve and appeal any denied or underpaid claims. • Assist in creation of standard appeal templates • Performs ongoing trend analysis on third party payer payment levels to ensure that reimbursement is in accordance with allowable amounts stated in agreements and contracts. Works with appropriate individuals to resolve discrepancies • Attend and participate in scheduled meetings. • Review and resolve payment variances for assigned insurance plans. • Perform adjustment and/or contractual write-offs when deemed appropriate • Responds to insurance company correspondence including requests for information and claim review • Researches and processes all refund requests within the insurance contractual obligations and state and federal laws • Answers billing office phone calls when needed • Performs other related duties as assigned to support the organization
KNOWLEDGE, SKILLS, AND ABILITIES: • Demonstrates critical thinking skills, ability to organize and respond to urgent or emergent situations. • Demonstrates decision-making skills based on accurate information and/or analysis of data. • Strong Communication skills. • Knowledgeable in all medical Commercial and Government insurance plans • Knowledge of medical terminology, CPT codes, ICD-10 codes and procedures, technical job knowledge, and Third-Party payer requirements and reimbursement rules. • Problem solving skills. • Patience and ability to manage stress. • Excellent typing and 10-key speed and accuracy. • Proficient use of Microsoft Office programs including World, Outlook, and strong Excel skills.
EDUCATION AND EXPERIENCE: • High School Diploma or GED • Three (3) years of Insurance Collections/billing Reimbursement experience in a physician and/or hospital setting • One (1) year experience with Workers Compensation
Job Posted by ApplicantPro

Worker's Compensation Denial Specialist

<h3>Job Description</h3>
Company Description
Monro, Inc. Monro, Inc. is one of the nation’s largest auto service companies and major tire retailer. We own and operate more than 1,200 stores in 32 states and our stock trades on the Nasdaq (MNRO). The Monro family of brands includes some the most recognizable names in the industry—Monro Auto Service and Tire Centers, Mr. Tire, Tire Choice, amongst many more regional chains. Our dominance is driven by teammates who strive to provide a five-star experience and deliver consistent value to our guests and shareholders. At Monro, we understand that a 5-star guest experience begins with a 5-star teammate experience. In fact, we’re currently investing more than $100 million in store improvements, new technology, and career development through our own Monro University training platform.
Destination Monro – Your Career is Here! Do you have what it takes to shape a better future for yourself and the automotive service industry? Our vision is to be America’s leading auto and tire centers, trusted by consumers as the best place in our neighborhoods for quality automotive maintenance and repairs. We’re looking for motivated individuals at every stage in their career who share our vision. Positions are available in our retail locations across our many brands, in field management, and in store operations at our Store Support Center in Rochester, New York. If you like helping others, as much as you like working on cars; if you enjoy being part of a team, solving problems, and building guest relationships; if you value honesty and integrity - we have a Destination for you at Monro. Contact us to learn more.  Destination Monro! – Your career is here.
Job Description
Position Summary:
You are responsible for providing a superior Guest Care experience and assisting in driving sales of automotive repair services and tires. This position is expected to contribute the growth of the business through strong sales presentations to our guest and product and service knowledge.  You must be comfortable answering the phone, inviting guest into our store, and making guests feel welcome during their visit.
Duties &amp; Responsibilities:
<ul>
<li>Successfully complete Monro's training program to enable Guest Care Specialist to execute the Monro selling process.</li>
<li>First point of contact for customers on the phone and in the store. Responsible for engaging customers, scheduling appointments, building trust, understanding needs, communicating processes and timelines, and presenting needed services following the Monro selling process. Responsible for the organization and productivity of the service business through estimate and invoice transactions.</li>
<li>Under the direction of management, assists in various aspects of customer care, work order completion and register assistance, facility maintenance, and outside purchase ordering.</li>
<li>This position is a secondary key carrier responsible for basic and detailed opening and closing responsibilities.</li>
<li>Follow all policies and procedures related to cash, credit, check, refund and return policies. Works with the management team to react to customer service issues, customer complaints, and/or business opportunities.</li>
<li>Able to understand and effectively communicate all products and services Monro offers to customers. </li>
<li>Partner with Management to produce a safe and health work environment that complies with all local, state, and federal laws, as well as with company policies and procedures.</li>
<li>Maintain an organized and neat customer waiting area.</li>
<li>Other duties as assigned.</li>
</ul>
Qualifications
Knowledge, Skills, and Abilities:
<ul>
<li>High school diploma or equivalent required.</li>
<li>Valid Driver's License.</li>
<li>One (1) year of sales experience needed.</li>
<li>Preferred One (1) year of related experience in the automotive service environment.</li>
<li>Strong verbal communication skills, able to accurately write sales work orders and effectively explain services to customers.</li>
<li>Strong problem-solving skills.</li>
<li>Ability to work, Days, Evenings, Weekends, Holidays</li>
</ul>
Physical Demands:
<ul>
<li>Must be able to frequently lift, carry, and place merchandise and supplies up to 50 pounds without assistance.</li>
<li>Frequent standing and walking for long periods of time.</li>
<li>Frequent reaching overhead and below the knees, including squatting, bending, stooping, kneeling, twisting.</li>
<li>Climb up and down ladders to retrieve and stock merchandise.</li>
<li>Communicate effectively in person, by telephone, or by using telecommunications equipment.</li>
<li>Enter and locate information on computer.</li>
<li>Safely operates a motor vehicle.</li>
</ul>
Additional Information
All your information will be kept confidential according to EEO guidelines.
Equal Opportunity Employer
Your next Destination!
Growth Opportunity: 
At Monro we’re committed to helping our teammates grow their career through the combination of coursework, demonstrating leadership skills and open opportunities. Our teammates receive on-the-job training, company sponsored certifications, as well as course curriculum in Monro University that empowers them to advance to the next level of their careers.
Monro, Inc. is an equal opportunity employer and affords equal opportunity to all applicants for all positions without regard to race, color, religion, sex, national origin, disability status, protected veteran status, or any other characteristic protected by law.

Guest Care Sales Specialist

<h3>Job Description</h3>
Job Description
Primary Accountability
The Revenue Cycle Specialist II will assist the Revenue Cycle Director and the Revenue Cycle Manager in operations.
Primary Responsibilities
1. Assist the Revenue Cycle Director in monitoring operations, including:
<ul>
<li>1.1. The monthly report of un-dropped charges in the doctors’ report.</li>
<li>1.2. Unapplied credit balances.</li>
<li>1.3. Patient payment refund.</li>
<li>1.4. Insurance verification for newborn hospital encounters.</li>
<li>1.5. Report on newborn hospital encounters.</li>
<li>1.6. Verification of Medicaid eligibility.</li>
</ul>
2. Assist the Revenue Cycle Director in monitoring staff to ensure accuracy and promptness of their tasks, specifically, reviewing work on:
<ul>
<li>2.1. Verify MBCHC patients’ insurance coverage for next-day appointments or walk-ins.</li>
<li>2.2. Providing training to MBCHC staff on effective insurance verification as needed.</li>
<li>2.3. The Insurance Verification reference sheet that outlines instructions by insurance plans.</li>
<li>2.4. Collection projects.</li>
</ul>
3. Assist the Revenue Cycle Director in reviewing the denials and rejections of insurance claims to assess patterns.
4. Assist the Revenue Cycle Director in determining how to reduce or eliminate insurance rejections and denials.
5. Assist the Revenue Cycle Director with the responsibilities associated with human resource functions.
6. Assist the Revenue Cycle Director in training staff on finance functions as needed.
7. Assist the Revenue Cycle Director in determining how best to maximize cash flow while maintaining and improving internal and external customer relations.
8. Assist the Revenue Cycle Director in serving as a key resource in all matters relating to billing.
Primary Attributes
1. General Development
<ul>
<li>1.1. Able to juggle multiple priorities.</li>
<li>1.2. Able to adjust to changing circumstances.</li>
<li>1.3. Able to organize time efficiently.</li>
<li>1.4. Able to serve as a liaison between patients and medical staff.</li>
<li>1.5. Maintain cordial relationships with staff, patients, and community members.</li>
</ul>
2. Professional and Technical Knowledge
<ul>
<li>2.1. Knowledge of insurance company practices regarding reimbursement and healthcare receivables.</li>
<li>2.2. At least 1 year experience at a federally qualified health center</li>
</ul>
3. Technical Skills
<ul>
<li>3.1. Proficiency in Microsoft Office Suite, especially Excel.</li>
<li>3.2. Able to use clerical and numerical skills in preparing drafts and documents from raw data.</li>
<li>3.3. Able to create letters, forms, and documents.</li>
</ul>
4. Communication Skills
<ul>
<li>4.1. Excellent written and oral communication skills.</li>
<li>4.2. Communicate complex concepts clearly and effectively to a general audience.</li>
</ul>
We are preferably seeking individuals with extensive experience in insurance verifications and a strong understanding of various insurance carriers.
Company DescriptionMiami Beach Community Health Center, Inc. (MBCHC) is a fully integrated ambulatory care medical facility that has been providing primary health care in Miami-Dade County since 1977. Our mission is to provide our patients with a patient-centered medical home with high quality, affordable primary health care, and specialty services, chronic disease management, and support services.
MBCHC has two locations on Miami Beach and one in North Miami. Services provided include internal medicine, family medicine, pediatrics, obstetrics and gynecology, HIV/AIDS services, dental, endocrinology, ophthalmology and optometry, psychiatry and behavioral health, podiatry, and geriatrics. All three locations have laboratory and pharmacy services. MBCHC pharmacies have 340B pricing. Free medication is available for patients through pharmaceutical company patient assistance programs for those who qualify. Free transportation and translation services are also available for those who need them. In addition, we offer assistance with case management such as enrollment in health insurance from the Affordable Care Act (“Obamacare”), enrollment in Medicare, and Healthy Start prenatal services. 
<h3>Company Description</h3>
Miami Beach Community Health Center, Inc. (MBCHC) is a fully integrated ambulatory care medical facility that has been providing primary health care in Miami-Dade County since 1977. Our mission is to provide our patients with a patient-centered medical home with high quality, affordable primary health care, and specialty services, chronic disease management, and support services.\r\n\r\nMBCHC has two locations on Miami Beach and one in North Miami. Services provided include internal medicine, family medicine, pediatrics, obstetrics and gynecology, HIV/AIDS services, dental, endocrinology, ophthalmology and optometry, psychiatry and behavioral health, podiatry, and geriatrics. All three locations have laboratory and pharmacy services. MBCHC pharmacies have 340B pricing. Free medication is available for patients through pharmaceutical company patient assistance programs for those who qualify. Free transportation and translation services are also available for those who need them. In addition, we offer assistance with case management such as enrollment in health insurance from the Affordable Care Act (“Obamacare”), enrollment in Medicare, and Healthy Start prenatal services.

Revenue Cycle Specialist II

<h3>Job Description</h3>
Job Description
A large established behavioral health practice located in Chicago's Loop is looking to hire an experienced Revenue Cycle Specialist. The ideal candidate will be a team player, problem-solver, excellent communicator, and diligent about benefit verification, claims, collections, and revenue cycle management. This position is ideal for someone who enjoys multi-tasking, taking on challenges, and who seeks variety.
We are looking for a Revenue Cycle Specialist to work at our Chicago headquarters. This is a full-time position Monday-Friday, 8:00 am to 5:00 pm.
The position is a hybrid role, working from our Chicago Loop office three days per week and two days from home.
Duties and Responsibilities Include:
<ul>
<li>Verifies behavioral insurance benefits for new and existing clients</li>
<li>Assists with completing client intake packages as needed</li>
<li>Works daily aging reports</li>
<li>Resolves any insurance claim denials, coordination of benefits, or clearinghouse issues</li>
<li>Works with clients to address and resolve any credit card and/or copay issues</li>
<li>Manages overpayments and initiates takebacks with insurance companies</li>
<li>Reconciles past due accounts through processing claims and ERA’s</li>
<li>Troubleshoots aging accounts with clients and insurance companies</li>
<li>Follows up on claims that are pending payment to ensure submissions were accurate</li>
<li>Oversees the refund requests</li>
<li>Assists with medical record requests as needed</li>
<li>Submits or resubmits claims and/or corrected claims for payment</li>
<li>Makes outbound collection contacts via email or phone calls in a professional manner while keeping and improving customer relations</li>
</ul>
Job Requirements:
<ul>
<li>Minimum two years’ experience in a medical billing and collection environment</li>
<li>Strong oral and written communication skills</li>
<li>Ability to work as part of a multi-disciplinary team</li>
<li>Effective problem solving and decision-making abilities</li>
<li>Solid computer skills are required</li>
<li>Strong organizational skills</li>
<li>Must be a fast learner, willing to learn, takes initiative, has a passion for helping others and is eager to work and accomplish goals in a timely manner</li>
</ul>
Proficiency in the following areas is preferred:
<ul>
<li>Knowledge of insurance guidelines and other payer requirements and systems</li>
<li>Familiarity with CPT and ICD-10 Coding</li>
<li>Customer service skills for interacting with clients regarding medical claims and payments, including communicating with clients and family members of diverse ages and backgrounds</li>
<li>Problem-solving skills to research and resolve discrepancies, denials, appeals, collections. A calm manner and patience working with either clients or insurers during this process</li>
<li>Knowledge of accounting and bookkeeping procedures</li>
<li>Knowledge of medical terminology likely to be encountered in medical claims</li>
<li>Maintaining client confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA)</li>
</ul>

Revenue Cycle Specialist

<h3>Job Description</h3>
Resident Billing &amp; Collections Specialist II
Wernersville, PA 
Phoebe Ministries is hiring a Full-time Resident Billing &amp; Collections Specialist II to join our long-term care facility in Wernersville, PA. 
We show our employees our appreciation for their contribution towards carrying out our mission of enriching the lives of seniors. Phoebe Berks has a beautiful, updated campus and high standards of excellence for all our employees.
Phoebe offers great PERKS and BENEFITS:
<ul>
<li>Generous Paid Annual Leave Time PLUS the ability to sell back unused time twice a year!!!</li>
<li>Full Benefit Package, including Health, Dental, Vision and Life Insurance</li>
<li>Tuition Reimbursement</li>
<li>Service Awards &amp; Recognition Gift Cards</li>
</ul>
Responsibilities for a Resident Billing &amp; Collections Specialist II with Phoebe Berks:
The Resident Billing &amp; Collections Specialist II (RBCS) will engage with residents and families during their stay to educate them regarding insurance coverage and potential resident costs.  The RBCS reconciles the daily census for all SNF residents and verifies insurance coverage.  Generates monthly bills for all SNF residents and manages private pay and miscellaneous cash receipts.  Completes risk assessments for current SNF residents to determine Medicaid eligibility.  The RBCS is responsible for all Private Pay Collections and Accounts Receivable Management.  The RBCS delivers exceptional customer service by responding to all inquiries in a timely manner.          
Requirements for a Resident Billing &amp; Collections Specialist II with Phoebe Berks:
<ul>
<li>High School Diploma.</li>
<li>Minimum one (1) year experience desired, but not necessary.</li>
<li>Proficient reading, writing, grammar, and mathematical skills; above average word processing/data entry skills.  </li>
<li>Working knowledge of SNF resident registration, billing, accounts receivable, cash management, industry regulations, business office operations, insurance benefits and refund processing.</li>
<li>Successful candidates are those who thrive in a positive and respectful Customer Driven Culture and exemplify the organization’s Faith in Action Mission, Vision, and Values.</li>
</ul>
Apply today!  We can’t wait to meet you!
Phoebe is an equal opportunity employer.
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