- Compiles and maintains current and accurate data for all affiliates.
- Completes affiliate enrollment applications; monitors applications and follows-up as needed.
- Vendor/Insurance Password Management
- Maintains clear documentation of application status for enrollment.
- Maintains knowledge of current health plan and agency requirements for enrollment.
- Enters and maintains affiliate information in clearinghouse databases and payer systems.
- Audits clearinghouse, bank records, and lockbox for current and accurate affiliate information.
- Monitors timeliness and effectiveness of enrollment activities, ensuring that outstanding requests processed accordingly.
- Communicates/facilitates special projects and requests.
- Compiles and prepares various status reports to analyze trends and make recommendations.
- Contributes to the team effort by completing other tasks/projects as needed.
- Investigates Inquiries for Enrollment and Credentialing, Problem Solving
- Create and maintain a positive relationship with Affiliates, Vendors/Payers and other EyeSouth Departments
- Minimum of 1-3 years experience in ERA, EDI, ELG enrollments with clearinghouse, as well as EFT and lockbox connections.
- Experience with Account Receivable and Denial Management preferred.
- Intermediate computer skills including Smartsheets and Microsoft Office; especially Word, Excel, and Teams.
- Candidate possesses strong oral and written communication skills which are essential due to communication with providers and healthcare administrators.
- The candidate must be able to maintain a strict level of confidentiality.
- The roles and responsibilities outlined above should not be construed as all encompassing. Other duties, responsibilities, and qualifications may be required and/or assigned as necessary.
- Demonstrated success working in a team environment focused on meeting organization goals and objectives is necessary.
- Self-motivated with strong organizational skills and superior attention to detail.
- Ability to review documents for accuracy, detail oriented.
- Ability to work well under pressure.
- Ability to multi-task, set priorities and follow through without direct supervision.
- Effectively communicate with insurers, colleagues, management and staff.
- Detail oriented and tolerant of frequent interruptions and distractions.
- Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.
- Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
- Must possess strong ethics and a high level of personal and professional integrity.
- Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes.
- Medical
- Dental
- Vision
- 401k w/ Match
- HSA/FSA
- Telemedicine
- Generous PTO Package
- Employee Discounts and Perks
- Employee Assistance Program
- Group Life/AD&D
- Short Term Disability Insurance
- Long Term Disability Insurance
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RCM Integration Specialist - Atlanta, United States - EyeSouth Partners
Description
Company Overview:
Headquartered in Atlanta, GA, EyeSouth Partners is an eye care physician services organization committed to partnering with leading physicians to build a premier network of eye care services in throughout the Southeast. EyeSouths partner practices clinical mission is to provide high quality medical and surgical specialty eye care. EyeSouth supports its affiliated practices and physician partners with capital, administrative resources, operating expertise, and strategic guidance with an absolute focus on clinical quality and a patient-first culture.
EyeSouths affiliate network consists of 30 practices with over 260 doctors providing medical and surgical eye care services at approximately 150 locations including 19 surgery centers throughout Georgia, Louisiana, North Carolina, Florida, Tennessee, Texas, Alabama, Ohio, Kentucky, Pennsylvania, and Illinois.
Position Summary:We are actively recruiting for an Integration Specialist to join our growing team at EyeSouth Partners.
If you wish to join a growing team with favorable benefits and perks, while contributing to a best-in-class organization, please apply with your resume.
Responsible for all aspects of the RCM Enrollment, EDI, ERA, EFT, Eligibility, and Lockbox connections. Including Password Management for all medical providers who provide patient care, clinics, and facilities within the EyeSouth Partners Network. Responsible for electronic connections are confirmed and active through clearinghouse. Maintain up-to-date data for each status for electronic connections and documentation for each affiliates health payer enrollments.
**Applicants who live and plan to work from the following states will not be considered at this time: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Idaho, Montana, Maryland, Massachusetts, Michigan, Nevada, New Mexico, Oregon, New Hampshire, New Jersey, Utah, New York, Rhode Island, Washington, and Wyoming. Thank you for your interest.
Responsibilities:We offer a competitive benefits package to our employees:
We also offer the following benefits for FREE:
EyeSouth Partners is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
