Senior Administrative Assistant to the Director of Inpatient/Outpatient Rehabilitation Services, Home Medical Equipment and Sleep Center. Coordinates arrangements for meetings and conferences, including scheduling, preparing materials, recording and preparing minutes. Maintains calendars and schedules of director and managers. Assists in developing and monitoring departmental budgets, forecasts and financial activity by gathering appropriate reports and records, tracking expenditures, and identifying and resolving errors and discrepancies. Handles significant volume of sensitive and confidential data, including records related to personnel, payroll, attendance, billing, work and purchase orders. Prepares, maintains and processes a variety of records and logs. Assists in preparing complex administrative and statistical reports and projects. Uses knowledge of hospital policies and procedures to perform difficult information gathering, interpret and analyze data. Prepares reports and analyses for review by director. Supports director, manager and employees through a variety of tasks related to organization and communication. Responsible for confidential and time sensitive material. Identifies and implements solutions to problems and issues affecting accurate scheduling of inpatient rehabilitation, acute care, medical and ortho therapy services. Identifies and participates in continuous quality improvement initiatives with both the front desk staff and clinical staffs' functional areas in order to streamline processes. Provides hands on supervision of day to day operations of front desk staff to ensure efficient, responsive operations to achieve optimal area performance and colleague productivity goals. Ensures that all staff are adequately trained to effectively perform their required responsibilities. Provides team members additional training if needed. Effectively organizes training materials for new employees. Participates in process and procedure development.

Essential Functions and Responsibilities:Day to day operations of front desk/check-in/out staff and services provided to ensure efficient, fiscally responsible and customer responsive operations. Ensures that front office staff are adequately trained to effectively perform their required responsibilities and provided with an overview of the Front Desk performance goals and objectives. Provides team members additional training if needed. Effectively organizes training materials for new employees. Participates in process and procedure development. Works collaboratively with the Office leadership team to improve front desk services, offer additional front desk/check in/out services, and achieve front desk/check in/out goals. Check-in patients. Interviews patients, gathers information to assure accurate and timely claims submission. Interprets information collected to determine and create comprehensive visit-specific billing records. Provides information to patients concerning hospital policies and regulatory requirements utilizing effective interpersonal and guest-relations skills. Determines appropriate payment required at point of registration (deposits, co-pays, minimum charges and non-covered services.) Collects payment at time of registration or check-out. Verifies procedural and diagnosis codes submitted by service departments and physicians to assure accuracy for claims submission and adjudication of reimbursement. Verifies insurance eligibility with payors. Determines benefits and ensures authorization requirement are met. Interacts with ordering provider and patient to coordinate service and insurance requirements. Contacts patients to discuss eligibility and benefits and requirements specific to clinical services.

Performs all billing and follow-up functions, including the investigation of over-payments, underpayments, payment delays resulting from denied, rejected and/or pending claims, with the objective of appropriately maximizing reimbursement in the most timely manner. Evaluates accounts, resubmits claims, and performs refunds, adjustments, write-offs and/or balance reversals, if charges were improperly billed or if payments were incorrect. Communicates with physicians and their office staff, Medical Records/Health Information Management, Utilization Review/Case Management and Nursing staff, as required to clarify billing discrepancies, and obtain demographic, clinical, financial and insurance information. Submits claims daily, including the maintenance of bill holds and the correction of errors in an effort to provide timely, accurate billing services. Edits UB-04 (and where appropriate HCFA-1500) claim forms within the patient accounting system ensuring that correct ICD-9/10 diagnosis, HCPCS and CPT procedure codes are utilized. Researches any error claims and makes necessary corrections for clean claim production and submission on an as needed basis.

Primary duties include verifying patient benefits, also evaluates patient eligibility and helps patients sign up for financial support, drug assistance, co-pay assistance, and other assistance programs. Potential programs may include state, county, federal, and/or drug manufacturer assistance programs. Available to patients and families to answer questions regarding their insurance and give estimates of co-pay amounts. Obtaining authorizations for Chemotherapy. Assists patients and families with resolving financial, psychosocial, functional, and administrative issues by advising of options and referring to appropriate resources. Serves as a liaison between patient and clinical staff, administration, physicians, managed care companies, and community/external resources to coordinate/maximize resources and identify/resolve barriers to the plan of care.

Primary duties include, but are not limited to: timely and accurate claim submission, resolution of non-payment accounts utilizing monthly aging reports. Have constant contact with Medicare and Medicare Advantage carriers through website, email or telephone to resolve outstanding accounts. Analyze and resolve moderately complex insurance denials. Appeal and/or resubmit unresolved claims to insurance carriers. Research and respond to insurance correspondence. Research and obtain required documents to resolve misdirected payment issues. Secondary duties include but are not limited to: send secondary claims upon processing of primary insurance. Data entry of all patient demographic, guarantor and insurance information, posting procedures and insurance/patient payments.

Blue Cross Blue Shield Insurance Specialist: Primary duties included: verifying patient benefits. Obtaining inpatient authorizations for patient stays. Bill coded claims to BCBS. Post payments from BCBS. Timely follow up on insurance claim denials, exceptions or exclusions. Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days.

Ensure all claims are submitted with a goal of zero errors. Verifies completeness and accuracy of all claims prior to submission. Accurately Post all insurance payments by line item. Make necessary arrangements for medical records requests, completion of additional information requests. Assign ICD-9 to physicians diagnosis and insure correct level of service and various other CPT codes Send secondary claims upon processing of primary insurance. Monthly processing of Patient statements. Answer and resolve patient billing inquires. Follow up on Insurance and patient aging. Re-submit insurance claims as necessary

MA duties, ensure all MAs provide quality medical treatment. Manage and train MAs to continually improve performance and skill level. Delegate the documentation of weekly eye-wash inspections, temperature logs, MA mobile triage bags, change of sharps container. Document all procedures and verbal/visual advice given to the patient or patient representative. Document and maintain immunizations records. Schedules certified medical assistants across all clinical areas to ensure continuity of schedule and efficiency of staff, while meeting clinical needs as defined by doctors and supervisor. Billing functions, Accurately input procedure and diagnosis codes into billing software to generate invoices. File insurance claims electronically. Work edits in electronic billing system, fix edits and resubmitting claims. Print and mail statements to patients Regularly obtain status of open claims in order to decrease company\'s AR and to increase income. Process denials for appeal, reprocessing or write-offs.

Billing functions, including medical coding, charge entry, claims, payment posting, and reimbursement management. Review patients’ encounter forms to verify diagnosis codes, and reconcile codes against services rendered. Accurately input procedure and diagnosis codes into billing software to generate invoices. File insurance claims electronically. Work edits in electronic billing system, fix edits and resubmitting claims. Print and mail statements to patients Regularly obtain status of open claims in order to decrease company\'s AR and to increase income. Process denials for appeal, reprocessing or write-offs. Correspond with patients to collect monies due after time of service; including but not limited to past due balances and insurance remittances made to the patient Receptionist functions, Greeting arriving patients, checking patients in and out for the visits, answering phones, screening calls and taking messages. Handling incoming and outgoing mail. Preparing electronic and written correspondence. Supporting office security by monitoring incoming and outgoing visitors.