Case Information & Reconciliation Specialist

Description

Company Overview

National Partners in Healthcare (NPH) is a progressive healthcare company specializing in anesthesiology. We partner with physicians and health systems to deliver high quality care, aligning synergies and best practices to achieve superior outcomes. As a leader in the industry, we believe in developing a foundation of trust, transparency, and excellence in everything we do. The success of our company has created excellent career advancement opportunities that support a healthy work/life balance.

Position Summary

The Case Information/Reconciliation Specialist must be highly organized and able to work in a fast-paced medical billing environment, with a focus on accuracy, attention to detail and timeliness. Candidate should be comfortable working with computers, spreadsheets, hospital EMR’s, outlook and well versed in various types of filing systems, medical documents, communication to providers and great follow up skills.  Able to meet deadlines/RCM quotas daily, keeping all assigned tasks current. This position will be required on an assigned schedule pick up and process case documents from various facilities which are listed below processing them upon return from that location.  Locations may change as new locations are added/removed or electronic file feeds are implemented. Company will reimburse for mileage. 

Facilities: 

• Salt Lake Regional: 1050 E South Temple, Salt Lake City, UT 84102
• Jordan Valley Medical Center: 3580 W 9000 S, West Jordan, UT 84088
• Jordan Valley Medical Center West: 3460 South 4155 West, West Valley City, UT 84120

Essential Duties and Responsibilities:

• Reviewing incoming case documents for compliant documentation by the provider that has been uploaded to the pending reconciliation que in eBridge or Hank AI Claim Maker (ie: Correct DOS, proper attachments, correct patient stickers, signed, dated etc. blocks, anesthesia method etc.) Making necessary notations, adding to tracker, moving batch to next pending que timely.
• Emailing providers requesting for an amended record to be performed on those cases where non-compliant records were received. 
• Keeping a tracker via spreadsheet of requests, following up on those requests timely.
• Keeping Charge Capture Tracker daily with incoming batch information by division, if a day does not reflect a delivery, reaching out to the appropriate area to check status. 
• Emailing/faxing requests or utilizing hospital portals to obtain needed documentation to complete a case.  Keeping requests on tracker, timeliness of follow up ensuring documents are received before timely filing deadlines. 
• Maintaining Case Documents email with returned amended/missing requested records.  Batching and reuploading these cases to eBridge or Hank AI Claim Maker for processing, notating tracker of completed record request. 
• Maintaining personal NPH email of any requests. 
• Weekly on specified days of the week/time period travel to assigned facilities to retrieve hard copy case documents/OR Schedules for processing
• Batch hard copy cases in groupings of no more than 25, fill out and attach batch cover sheet for those cases that are manually uploaded/reuploaded to eBridge or Hank AI Claim Maker depending on division. 
• Scan uncoded, batched cases, uploading them to eBridge or Hank AI Claim Maker depending on division our medical record document housing system, assigning to appropriate que, filling out all indexes appropriately.  
• If/when requested obtain needed documentation for coding/billing team when necessary, providing back to staff member timely through the scanning process utilizing eBridge or Hank AI depending on division. 
• Reconciliation of incoming hospital schedules to NPH systems looking for missing cases, if case is identified missing, obtain missing case information through previously mentioned means, uploading to eBridge, or Hank AI Claim Maker depending on division, placing in appropriate que.   
• Perform quality check of scanned images and make appropriate corrections before uploading into ebridge our medical record document housing system. 
• Produces clean/clear/legible, digital copies of documents for retention purposes.
• After scanning and uploading to eBridge or Hank AI Claim Maker, box the scanned batch and label for tracking, auditing, storage purposes.
• Send to AZ Regional Office processed case documents on a periodic schedule by Fedex. 
• Send to Corporate Office any picked up Mail, checks weekly.  
• Keep direct manager apprised of any issues, trends, missing electronic files, missing DOS’s/facility cases not received through courier or electronic file uploads by our IT department.
• Maintain good work habits, including reporting to work on time and adhering to standard work, safety procedures and NPH employee handbook.
• Ability to exercise sound judgment and effective decision-making skills to accomplish goals and creatively problem-solve issues within scope of position.
• Detail-oriented individual with sound judgment with a focus on having the job completed in a timely manner, accurately within daily deadlines provided. 
• Maintains strictest confidentiality.

Non-Essential Duties and Responsibilities:

• Perform other duties as assigned.
• Responsibilities can be modified/changed by direct manager.
• Regular, predictable attendance is an essential function of the job.
• Reliable Transportation 

Qualifications

Experience and Education/Licensing/Certification:

         High School graduate or GED equivalent

• Two years in RCM medical documents, auditing and administrative office experience preferred; one year required.

Knowledge and Skills:

• Knowledge of organization policies, procedures, and systems
• Good understanding of medical revenue cycle
• Skill in computer applications including MS Word, MS Excel. 
• Skill in verbal and written communication. 
• Skill in gathering and reporting information. 
• Ability to work effectively with staff, physicians, and external customers.  Must display teamwork attitude and good inter-personal skills.
• Must have a pleasant disposition and high tolerance level ability to meet goals, deadlines, communicated expectations.  
• Ability to work independently with limited supervision, handles stressful situations – calmly.