Back Office Specialist at 5000 Wellstar Medical Group, LLC

, Georgia, United States -

Full Time

Start Date

Immediate

Expiry Date

25 Apr, 26

Salary

0.0

Posted On

25 Jan, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Effective Communication, Attention To Detail, Problem Solving, Critical Thinking, Data Entry, Professionalism, Active Listening, Patient Registration Systems, Microsoft Office Suite

Industry

Hospitals and Health Care

Description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives. Work Shift Job Summary: The Back Office Specialist (BOS) position functions under the direction of the Front Office Supervisor, Manager, or Director. The position is responsible for submitting authorizations for assigned clinics, updated approved authorization status into WebPT and EPIC. In addition, this position is responsible for working and resolving all denials for their assigned clinics. This position is responsible for denial management tracking and trending by denial reason and value, determination of root cause of denials, and translating root causes into timely and meaningful information to mitigate future denials. Assists leadership with problem solving and conducting Root Cause Analysis (RCA) when trends and opportunities are identified. Prepares weekly WQ and Denial presentation for leadership and schedules routine meetings to review opportunities for improving metrics with leaders. Participates in mentoring team members at the request of leadership to support ongoing performance improvement of department key performance indicators (KPIs) Core Responsibilities and Essential Functions: 1. Leadership and Planning a. Facilitates a positive work environment and assists with communicating WQ opportunities to team members,. b. Promptly notifies assigned clinics of any situations which may have a negative impact to patient care/approval for authorizations. c. Attends all departmental, and system-wide/interdepartmental meetings as needed. d. Leads by example, assisting in projects, working as a positive team member, and rounding and mentoring of staff for optimal performance as appropriate to share WQ trends and opportunities. e. Maintains orderly and clean work environment, commensurate with the public expectations of a healthcare organization. f. Participates and represents the department and hospital committees and special projects and assumes accountability as appropriate. g. Participates in meeting the goals and objectives of the Op Rehab department. h. Collaborates with leadership teams to develop and implement goals, objectives and Action Plans for the department that lead to performance improvement. i. Informs Management of non-compliance with WellStar/department policies and procedures resulting in increased accounts with WQ holds or delay in Medicare Certs being returned 2. Quality/ Safety a. Participates in the development of new educational programs/updates to employees. b. Participates in quality and performance monitoring and reporting. Compiles and distributes data from management reports in a timely and accurate manner. Works with Supervisor to analyze data to make changes as appropriate. c. Takes initiative to appropriately investigate and resolve WQ issues as they arise. d. Understands and follows system and department policies and procedures. e. Assists with investigating account issues, such as denials, tracking and trending problems, and recommending improvement measures to leadership as appropriate. f. Submits authorizations within 24hrs of notification and makes appropriate notes to OP Rehab EMR and EPIC. g. Monitors, ensures maintenance and resolves accounts, DNB/Denials, claim, and other related Workqueues. h. Manages and ensures compliance of Medicare Certification tracking and updating log. i. Participates in weekly Denial resolution for respective facility. j. Ensures quality and actively participates in initiatives which impact the overall success of Outpatient Rehab financial goals. 3. Budget/Financial a. Exercises good judgement with account disposition to ensure clean claims. b. Understands and ensures adherence to system and department policies and programs. c. Works with management to meet all financial related goals. d. Collaborates effectively with department Managers to maximize cash flow and minimize account errors. 4. Customer Service a. Demonstrates positive attitude with all internal and external customers. b. Resolves patient, physician, interdepartmental and other customer issues in a timely and appropriate manner. c. Demonstrates ability to tactfully handle difficult situations through an approach that reflects consistency. d. Maintains positive relationships with other department personnel. e. Pursues excellence in all areas related to customer service, including service recovery. Performs other duties as assigned Complies with all Wellstar Health System policies, standards of work, and code of conduct. Required Minimum Education: High School Diploma General or GED General Required Minimum License(s) and Certification(s): All certifications are required upon hire unless otherwise stated. Additional License(s) and Certification(s): Required Minimum Experience: Minimum 3 years Front Office Experience Required Minimum 1 year Authorization and claim denial experience Preferred Required Minimum Skills: Effective communication skills (both written and verbal) with the ability to communicate with various members of the healthcare team. High attention to detail, self-directed and a positive attitude are essential. High Effective problem solving and critical thinking skills. High Typing or data entry competency of at least 40 words/minute. Medium Demonstrated professionalism, effective communication skills and active listening skills. High Working knowledge of patient registration systems and intermediate Microsoft Office Suite are preferred. Medium Join us and discover the support to do more meaningful work—and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.

Responsibilities

The Back Office Specialist is responsible for submitting authorizations, managing denials, and preparing presentations for leadership. They also assist in problem-solving and mentoring team members to improve departmental performance.