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

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 must 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.

Essential Duties and Responsibilities:

· Reconciliation of Front-End incoming case documents for compliant documentation by the provider that has been uploaded to the pending reconciliation que in eBridge (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.

· Reconciliation of incoming hospital schedules during Front End Reconciliation when OR schedule is attached to confirm against cases all received, if any are “missing” reach out to appropriate contact or pull from the facility portal we access is available to department.

· Reconciliation of cases Back-End to confirm receipt and billing of each case. If any case is identified as missing/not billed perform follow up/actions until resolved and case/service is billed. Utilization of eBridge, facility portals, Connect, Hank AI, SFTP, outlook or any other tools available to the team not currently mentioned.

· Back-End Reconciliation performed by utilizing Teams Reconciliation que, spreadsheets or schedules provided by various sources to perform Back- End Reconciliation.

· Front/Back End Reconciliation - Emailing providers with education, requested back up documents or requesting for an amended record to be performed on those cases where non-compliant records were received. Clear, prompt communication to all providers.

· Front/Back-End Reconciliation to Keep a tracker via spreadsheet of requests/communications, following up on those requests timely.

· Front-End Reconciliation to keep 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.

· Front/Back-End Reconciliation - 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.

· Front/Back-End Reconciliation - Maintaining Case Documents email with returned amended/missing requested records. Batching and reuploading these cases to eBridge or Hank AI for processing, notating tracker of completed record request.

· All positions Maintaining personal NPH email of any requests.

· Front/Back End Reconciliation - Batch 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. (If assigned division requires)

· Front/Back End Reconciliation - Scan uncoded, batched cases, uploading them to eBridge or Hank AI our medical record document housing system, assigning to appropriate que, filling out all indexes appropriately.

· Front/Back End Reconciliation - 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.

· Front/Back End Reconciliation - Perform quality check of scanned images and make appropriate corrections before uploading into ebridge or Hank AO our medical record document housing systems.

· Front/Back End Reconciliation - Produces clean/clear/legible, digital copies of documents for retention purposes.

· Front/Back End Reconciliation - After scanning and uploading to eBridge or Hank AI, box the scanned batch and label for tracking, auditing, storage purposes. For those divisions impacted.

· Front/Back End Reconciliation - When appropriate, disposal of documents into security receptacles to be shredded and recycled.

· Front/Back End Reconciliation - 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 or any other source.

· Front/Back End Reconciliation - Keep direct manager apprised of frequent delinquencies or continuous failure to submit compliant documented anesthesia documents/records. Providing Division/Provider and background of issue.

· Front/Back End Reconciliation - Maintain good work habits, including reporting to work on time and adhering to standard work, safety procedures and NPH employee handbook.

· Front/Back End Reconciliation - Ability to exercise sound judgment and effective decision-making skills to accomplish goals and creatively problem-solve issues within scope of position.

· Front/Back End Reconciliation - Detail-oriented individual with sound judgment with a focus on having the job completed in a timely manner, accurately within daily deadlines provided.

· Front/Back End Reconciliation - Maintains strictest confidentiality.

Qualifications

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.

Minimum Qualifications:

Experience and Education/Licensing/Certification:

· High School graduate or GED equivalent

· Two years medical records, administrative office, auditing 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, outlook, SharePoint.

· 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.

Advantages of Working at NPH

• Competitive Pay and Benefits Package
• Annual Bonus
• Generous Paid Time Off
• 401K Contribution/Safe Harbor
• Flexible Work Environment
• Career Advancement Opportunities with a Growing Company
• On-site Fitness Center and Café
• Underground Parking with Badge Access

Please note that quoted salary ranges are not guarantees of what final salary offers may be. Base pay is based on market location and will vary depending on job-related knowledge, skills, and experience. Base pay is only one part of the Total Rewards that NPH provides to compensate and recognize our staff for their work. Full time positions are eligible for a discretionary bonus and a comprehensive benefits package.