The Provider Professional Services Coordinator. Is responsible for coordination of Physician Training and Billing related Activity to Bill and Code for optimal reimbursement, eCR Documentation of appropriate levels of E&M Levels Visits and Adjunct coding, Practice Demographics, Paysource Entry and Authorizations, Additional responsibilities include Payer Credentialing and Special Projects as needed.
ESSENTIAL DUTIES AND RESPONSIBILITIES
· Tracks Targets for Optimal Reimbursements of Provider's Productivity.
· Conducts Trainings at the Direction of Billing Director, Topics to Vary
· Conducts and Supports, Provider Audits both Targeted and Baselines as Outlined In Compliance Plan
· Maintains fee schedules and Paysource data in EHR system for the carriers
· Generates Productivity Reports, and Claims by CPT and Reports to Billing Director
· Weekly, run and review violation reports and work with clinical and medical staff to resolve errors
· Prepare end of month billing reports sent to finance to record revenue
· Perform Credentialing Duties Assigned
· Knowledge of E&M and Physician Coding and Documentation Requirements
· Ability to Conduct Training in an Organized and Effective Manner to Result in Improvements of Documentation with Provider Level Providers.
· Strong problem-solving skills, documentation skills, research and resolution skills, and data analysis skills
· Ability to communicate effectively verbally and in writing
· Ability to use CAQH System, Pecos, NPPS and Other Online Applications, Medicaid and Medicare Portals, DXC Technology.
· Maintain Relations and Contacts with Payers and needed.
· Conduct Follow-up and Status Request
· Furnish Speedy Response to Rapidly Changing Credentialing Request.
· Implement and Maintain Tracking of Status
· Ability to interact with Management, Providers, Insurance Payers in a professional manner.
· Ability to speak and write English fluently
· Ability to work independently and with a team in a fast-paced and high volume environment with emphasis on accuracy and timeliness
· Ensures client confidentiality in accordance with all federal, state, and local laws and regulations.
· Ability to promote and demonstrate Phoenix House's ICARE4 core values (Integrity, Collaboration, Accountability, Respect, Excellence, Forward Thinking) through work ethic, compliance, and attitude:
- Willingness to Help
To perform this position successfully, you must be able to perform each essential duty and responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties and responsibilities. The requirements listed below are representative of the knowledge, skill and/or ability required.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential duties and responsibilities of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties and responsibilities.
REGULARLY REQUIRED: to sit, use hands to finger, handle or feel objects, tools or controls; reach with hands and arms, and talk or hear.
OCCASIONALLY REQUIRED: to stand, walk, stoop, kneel or crouch and lift and/or move up to 10 pounds
The work environment characteristics described here are representative of those an employee encounters while performing the essential duties and responsibilities of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties and responsibilities.
Phoenix House requires background checks, drug testing, TB testing, verification of employment history, reference checks and possibly a medical exam, prior to employment.
Phoenix House is an Equal Opportunity Employer providing equality of opportunity to all who are protected against discrimination by law, regulation or executive order, including veterans and individuals with disabilities. EEO is the Law: Applicants and employees are protected under Federal law from discrimination. Click www.dol.gov/ofccp/regs/compliance/posters/pdf/eeopost.pdf to learn more.