United Surgical Partners International Inc (USPI)
OR Support Associate
United Surgical Partners International Inc (USPI), New York, New York, us, 10261
Position Summary
Manages a portfolio of practices and/or departments as assigned by the FGP Leadership team. Responsible for the day-to-day communications with physician practices and billing operations team, and revenue cycle reporting for the designated medical specialties. Requires analyzing financial reports, fee schedules, payer trends, staff productivity, and A/R measurement statistics. Accountable for assigned practices/services.
Job Responsibilities
Other related duties as assigned
Manages relationships with practices and functions as the primary point-of-contact for day-to-day issues, including ongoing communications, and coordination of projects, billing functions and other activities.
Monitors key performance indicators, Epic WQs, operational metrics, quality indicators, and/or reimbursement fee schedules for any trends.
Meets with practice(s) on a regular basis to discuss revenue cycle opportunities. Communicates with providers, patients, coders, or other responsible persons to update workflows to maximize revenue.
Monitor reports and assigned workqueues, ensuring coding, charge submission and accounts receivable follow-up is occurring on a timely basis.
Liaises with operations managers and practice management to resolve billing issues.
Performs regular and ad-hoc operational analyses related to processes, charges, claims, and/or accounts receivable.
Attends and presents at management and/or physician meetings.
Reviews billing resources, including CPT Procedural and ICD-10 manuals, payer policies, updates, and CMS publications to ensure services rendered are in compliance. Serve as resource to physicians, staff, and management regarding local and national coding and reimbursement policies.
Educate physicians, staff, and management on new and any changes to existing policies.
Adheres to general practice and FGP guidelines on compliance issues and patient confidentiality.
Develops and updates revenue cycle action plans on a monthly basis (or more frequently as needed); Ensures that the team produces action plans timely; reviews all data and reports with leadership before sharing.
Analyzes issues to identify trends in denial rates to focus improvement initiatives on, and charges that requires action. Recommends suggestions, ideas, and solutions to improve operational processes and workflows
May act as a financial counselor to patients who require assistance understanding their benefits and financial options. Act as the patient advocate with the patient and/or family members and liaison with the insurance companies to assist in obtaining insurance information.
Takes initiative to teach and share new information and provide constructive feedback; Communicate delays and work queue issues to management daily.
Works with practice operations to implement changes to improve revenue where necessary.
Ensures timely and accurate collection, preparation, and verification of billing information submitted to an outsourced billing service. Review billing collection and denial reports from the vendor and identify trends and recommend changes on how to improve issues.
Serves as a liaison for questions, data requests, and other inquiries. Review charge encounter forms for complete CPT code, ICD-10 code, and other required billing information on a daily basis, including but not limited to A/R follow-up and/or reimbursement management.
Compares coding to notes/documentation and communicate with providers to clarify errors.
Analyzes/audits notes and ensure the appropriate codes are charged in order to maintain billing compliance and prevent denials or works with appropriately credentialed staff to perform reviews.
Required Experience To qualify you must have a Bachelors Degree with a minimum of 3-6 years of relevant work experience or equivalent combination or training and relevant work experience. Ability to handle multiple tasks at once; good communication, interpersonal, and computer skills. Arrive on time for work and meetings. Ability to develop and maintain effective working relationships with staff and patients. High level of accuracy for reviewing charge batch submissions, preparing and presenting analyses, and in staff education. Maintain current insurance regulatory policies and requirements relevant to the specialty. Knowledge of medical terminology required. Familiar with standard office equipment and Microsoft Office applications. Qualified candidates must be able to effectively communicate with all levels of the organization.
Required Skills Knowledge of medical terminology required. Familiar with standard office equipment and Microsoft Office applications. Qualified candidates must be able to effectively communicate with all levels of the organization.
Possess outstanding interpersonal and communication skills to gain confidence and trust across the FGP
Demonstrated leadership skills with the ability to guide, direct, train and interact with staff and outside contacts
Strong conceptual and analytical abilities with the ability to identify issues and opportunities and be able to solve problems
Strong verbal and written communication skills as well as excellent listening skills
Ability to conceptualize work flow, develop plans and implement appropriate actions
Ability to create a positive environment where staff are valued and respected for their contributions
Professional demeanor
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Job Responsibilities
Other related duties as assigned
Manages relationships with practices and functions as the primary point-of-contact for day-to-day issues, including ongoing communications, and coordination of projects, billing functions and other activities.
Monitors key performance indicators, Epic WQs, operational metrics, quality indicators, and/or reimbursement fee schedules for any trends.
Meets with practice(s) on a regular basis to discuss revenue cycle opportunities. Communicates with providers, patients, coders, or other responsible persons to update workflows to maximize revenue.
Monitor reports and assigned workqueues, ensuring coding, charge submission and accounts receivable follow-up is occurring on a timely basis.
Liaises with operations managers and practice management to resolve billing issues.
Performs regular and ad-hoc operational analyses related to processes, charges, claims, and/or accounts receivable.
Attends and presents at management and/or physician meetings.
Reviews billing resources, including CPT Procedural and ICD-10 manuals, payer policies, updates, and CMS publications to ensure services rendered are in compliance. Serve as resource to physicians, staff, and management regarding local and national coding and reimbursement policies.
Educate physicians, staff, and management on new and any changes to existing policies.
Adheres to general practice and FGP guidelines on compliance issues and patient confidentiality.
Develops and updates revenue cycle action plans on a monthly basis (or more frequently as needed); Ensures that the team produces action plans timely; reviews all data and reports with leadership before sharing.
Analyzes issues to identify trends in denial rates to focus improvement initiatives on, and charges that requires action. Recommends suggestions, ideas, and solutions to improve operational processes and workflows
May act as a financial counselor to patients who require assistance understanding their benefits and financial options. Act as the patient advocate with the patient and/or family members and liaison with the insurance companies to assist in obtaining insurance information.
Takes initiative to teach and share new information and provide constructive feedback; Communicate delays and work queue issues to management daily.
Works with practice operations to implement changes to improve revenue where necessary.
Ensures timely and accurate collection, preparation, and verification of billing information submitted to an outsourced billing service. Review billing collection and denial reports from the vendor and identify trends and recommend changes on how to improve issues.
Serves as a liaison for questions, data requests, and other inquiries. Review charge encounter forms for complete CPT code, ICD-10 code, and other required billing information on a daily basis, including but not limited to A/R follow-up and/or reimbursement management.
Compares coding to notes/documentation and communicate with providers to clarify errors.
Analyzes/audits notes and ensure the appropriate codes are charged in order to maintain billing compliance and prevent denials or works with appropriately credentialed staff to perform reviews.
Required Experience To qualify you must have a Bachelors Degree with a minimum of 3-6 years of relevant work experience or equivalent combination or training and relevant work experience. Ability to handle multiple tasks at once; good communication, interpersonal, and computer skills. Arrive on time for work and meetings. Ability to develop and maintain effective working relationships with staff and patients. High level of accuracy for reviewing charge batch submissions, preparing and presenting analyses, and in staff education. Maintain current insurance regulatory policies and requirements relevant to the specialty. Knowledge of medical terminology required. Familiar with standard office equipment and Microsoft Office applications. Qualified candidates must be able to effectively communicate with all levels of the organization.
Required Skills Knowledge of medical terminology required. Familiar with standard office equipment and Microsoft Office applications. Qualified candidates must be able to effectively communicate with all levels of the organization.
Possess outstanding interpersonal and communication skills to gain confidence and trust across the FGP
Demonstrated leadership skills with the ability to guide, direct, train and interact with staff and outside contacts
Strong conceptual and analytical abilities with the ability to identify issues and opportunities and be able to solve problems
Strong verbal and written communication skills as well as excellent listening skills
Ability to conceptualize work flow, develop plans and implement appropriate actions
Ability to create a positive environment where staff are valued and respected for their contributions
Professional demeanor
#J-18808-Ljbffr