Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.
Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.
As Center for Bone & Joint Surgery of the palm Beaches continues to grow, we are looking for a Billing/Collections Specialist. Please see below for the functions and requirements for this position.
ESSENTIAL FUNCTIONS
Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.Updates and confirms as necessary to allow processing of claims to insurance plans.Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.Attaches referrals/authorizations to appointments/charges if available.Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.Identifies and communicates trends and/or potential issues to management team.Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.Other duties as assigned by leadership.Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information toAt Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
Competitive Health & Welfare BenefitsMonthly $43 stipend to use toward ancillary benefitsHSA with qualifying HDHP plans with company match401k plan with company matchEmployee Assistance Program that is available 24/7 to provide supportPaid Time OffPaid HolidaysMileage reimbursementand more...#CBJ
Read LessCenter for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.
Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.
As Center for Bone & Joint Surgery of the palm Beaches continues to grow, we are looking for a Billing/Collections Specialist. Please see below for the functions and requirements for this position.
ESSENTIAL FUNCTIONS
Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.Updates and confirms as necessary to allow processing of claims to insurance plans.Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.Attaches referrals/authorizations to appointments/charges if available.Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.Identifies and communicates trends and/or potential issues to management team.Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.Other duties as assigned by leadership.Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information toAt Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:
Competitive Health & Welfare BenefitsMonthly $43 stipend to use toward ancillary benefitsHSA with qualifying HDHP plans with company match401k plan with company matchEmployee Assistance Program that is available 24/7 to provide supportPaid Time OffPaid HolidaysMileage reimbursementand more...#CBJ
Read LessESSENTIAL FUNCTIONS
Manages the ongoing needs of physicians for credentialing of hospitals, insurances, and CME requirements.Establishes and maintains effective communication with physicians/providers and other departments as required.Organizes and manages specified provider meetings including but not limited to physician retreat, PA retreat, and other recognition programs as needed.Manages CME credits and reimbursements for all Providers.Provides ongoing supervision of the credentialing department.Manages the credentialing portion of our proprietary scheduling software.Functions as a member of the credentialing team.Train Credentialing and support staff on the correct use of credentialing software.Responsible for maintaining the privacy of all physicians, PA’s, and PT’s professional and personal information obtained in the performance of duties. Also responsible for support staff maintenance of privacy rules.EDUCATION
High school diploma/GED or equivalent working knowledge preferred.EXPERIENCE
Three plus years experience with credentialing physicians and providers.Three plus years experience in a manager or supervisory role within credentialing.KNOWLEDGE
Knowledge of the credentialing process.Knowledge of computer systems.Knowledge of credentialing paperwork and timelines.Knowledge of credentialing timelines and regulations.SKILLS
Skill in establishing good working relationships with internal and external customers.Skill in organizing daily work assignments for various providers.Skill in managing multiple work assignments and set priorities.Skill in meeting demanding deadlines.ABILITIES
Ability to establish good working relationships with internal and external customers.Ability to communicate effectively with physicians, credentialing agencies, and staff.Ability to be organized and efficient in daily work activities/projects.Ability to exercise independent judgment and decision-making abilities.ENVIRONMENTAL WORKING CONDITIONS
Normal office environment.Some travel within the community.PHYSICAL/MENTAL DEMANDS
Requires sitting and standing associated with a normal office environment.Some bending and stretching are required.Manual dexterity using a calculator and computer keyboard.ORGANIZATIONAL REQUIREMENTS
HOPCo Mission, Vision, and Values must be read and signed.This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities, and working conditions may change as needs evolve.
Read LessHealthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
HOPCo is the managing partner of Arizona-based entities, CORE Institute, Northern Arizona Orthopaedics, CORE Institute Specialty Hospital, Michigan-based CORE Institute, and Florida-based Southeast Orthopedic Specialists Clinics and Musculoskeletal Specialty Hospital.
As HOPCo continues to grow, we are looking for a Credentialing Specialist to join the Credentialing Team. Please see below for the functions and requirements for this position.
ESSENTIAL FUNCTIONS
Reviews and completes hospital and payor applications for all health care providers.Completes verification forms/letters for outside facilities.Maintain billing insurance grid, provider insurance grid and each individual physician’s spreadsheet up to date on current insurance changes.Track and maintain physician licensure(s), certification and CME credits.Maintain practitioner credentialing files.Maintain practitioner electronic file by keeping all applications/licensure current.Maintains all renewal applications for both hospitals/insurances.Has knowledge of Employee Handbook content along with established policies and procedures.Relies on instructions and pre-established guidelines to perform the functions of the job.Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.EDUCATION
High school diploma/GED or equivalent working knowledge preferred.EXPERIENCE
3-4 years of related Credentialing experience.REQUIREMENTS
Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers.Some knowledge of insurance billing and hospital credentialing a plus.KNOWLEDGE
Knowledge of the credentialing process.Knowledge of computer systems.Knowledge of credentialing paperwork and timelines.Knowledge of credentialing timelines and regulations.SKILLS
Skill in establishing good working relationships with internal and external customers.Skill in organizing daily work assignments for various providers.Skill in managing multiple work assignments and set priorities.ABILITIES
Ability to establish good working relationships with internal and external customers.Ability to communicate effectively with physicians, credentialing agencies and staff.Ability to be organized and efficient in daily work activities/projects.ENVIRONMENTAL WORKING CONDITIONS
Normal office environment.Some travel within community.PHYSICAL/MENTAL DEMANDS
Requires sitting and standing associated with a normal office environment.Some bending and stretching required.Manual dexterity using a calculator and computer keyboard.#HOP
Read LessHealthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
HOPCo is the managing partner of Arizona-based entities, CORE Institute, Northern Arizona Orthopaedics, CORE Institute Specialty Hospital, Michigan-based CORE Institute, and Florida-based Southeast Orthopedic Specialists Clinics and Musculoskeletal Specialty Hospital.
As HOPCo continues to grow, we are looking for a Credentialing Specialist to join the Credentialing Team. Please see below for the functions and requirements for this position.
ESSENTIAL FUNCTIONS
Reviews and completes hospital and payor applications for all health care providers.Completes verification forms/letters for outside facilities.Maintain billing insurance grid, provider insurance grid and each individual physician’s spreadsheet up to date on current insurance changes.Track and maintain physician licensure(s), certification and CME credits.Maintain practitioner credentialing files.Maintain practitioner electronic file by keeping all applications/licensure current.Maintains all renewal applications for both hospitals/insurances.Has knowledge of Employee Handbook content along with established policies and procedures.Relies on instructions and pre-established guidelines to perform the functions of the job.Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.EDUCATION
High school diploma/GED or equivalent working knowledge preferred.EXPERIENCE
3-4 years of related experienceREQUIREMENTS
Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers.Some knowledge of insurance billing and hospital credentialing a plus.KNOWLEDGE
Knowledge of the credentialing process.Knowledge of computer systems.Knowledge of credentialing paperwork and timelines.Knowledge of credentialing timelines and regulations.SKILLS
Skill in establishing good working relationships with internal and external customers.Skill in organizing daily work assignments for various providers.Skill in managing multiple work assignments and set priorities.ABILITIES
Ability to establish good working relationships with internal and external customers.Ability to communicate effectively with physicians, credentialing agencies and staff.Ability to be organized and efficient in daily work activities/projects.ENVIRONMENTAL WORKING CONDITIONS
Normal office environment.Some travel within community.PHYSICAL/MENTAL DEMANDS
Requires sitting and standing associated with a normal office environment.Some bending and stretching required.Manual dexterity using a calculator and computer keyboard.#HOP
Read LessESSENTIAL FUNCTIONS
· Reviews and completes hospital and payor applications for all health care providers.
· Completes verification forms/letters for outside facilities.
· Maintain billing insurance grid, provider insurance grid, and each physician’s spreadsheet up to date on current insurance changes.
· Track and maintain physician licensure(s), certification, and CME credits.
· Maintain practitioner credentialing files.
· Maintain practitioner electronic file by keeping all applications/licensure current.
· Maintains all renewal applications for both hospitals/insurances.
· Has knowledge of Employee Handbook content along with established policies and procedures.
· Relies on instructions and pre-established guidelines to perform the functions of the job.
· Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.
EDUCATION
· High school diploma/GED or equivalent working knowledge preferred.
EXPERIENCE
· 3-4 years of Credentialing experience
REQUIREMENTS
· Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors, and the public
· Must be capable of establishing good working relationships with both internal and external customers.
· Some knowledge of insurance billing and hospital credentialing is a plus.
KNOWLEDGE
· Knowledge of the credentialing process.
· Knowledge of computer systems.
· Knowledge of credentialing paperwork and timelines.
· Knowledge of credentialing timelines and regulations.
SKILLS
· Skill in establishing good working relationships with internal and external customers.
· Skill in organizing daily work assignments for various providers.
· Skill in managing multiple work assignments and set priorities.
ABILITIES
· Ability to establish good working relationships with internal and external customers.
· Ability to communicate effectively with physicians, credentialing agencies, and staff.
· Ability to be organized and efficient in daily work activities/projects.
ENVIRONMENTAL WORKING CONDITIONS
· Normal office environment.
· Some travel within the community.
MENTAL DEMANDS
· Requires sitting and standing associated with a normal office environment.
· Some bending and stretching are required.
· Manual dexterity using a calculator and computer keyboard.
Healthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
HOPCo is the managing partner of Arizona-based entities, CORE Institute, Northern Arizona Orthopaedics, CORE Institute Specialty Hospital, Michigan-based CORE Institute, and Florida-based Southeast Orthopedic Specialists Clinics and Musculoskeletal Specialty Hospital.
As HOPCo continues to grow, we are looking for a Credentialing Specialist to join the Credentialing Team. Please see below for the functions and requirements for this position.
ESSENTIAL FUNCTIONS
Reviews and completes hospital and payor applications for all health care providers.Completes verification forms/letters for outside facilities.Maintain billing insurance grid, provider insurance grid and each individual physician’s spreadsheet up to date on current insurance changes.Track and maintain physician licensure(s), certification and CME credits.Maintain practitioner credentialing files.Maintain practitioner electronic file by keeping all applications/licensure current.Maintains all renewal applications for both hospitals/insurances.Has knowledge of Employee Handbook content along with established policies and procedures.Relies on instructions and pre-established guidelines to perform the functions of the job.Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.EDUCATION
High school diploma/GED or equivalent working knowledge preferred.EXPERIENCE
3-4 years of related experienceREQUIREMENTS
Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers.Some knowledge of insurance billing and hospital credentialing a plus.KNOWLEDGE
Knowledge of the credentialing process.Knowledge of computer systems.Knowledge of credentialing paperwork and timelines.Knowledge of credentialing timelines and regulations.SKILLS
Skill in establishing good working relationships with internal and external customers.Skill in organizing daily work assignments for various providers.Skill in managing multiple work assignments and set priorities.ABILITIES
Ability to establish good working relationships with internal and external customers.Ability to communicate effectively with physicians, credentialing agencies and staff.Ability to be organized and efficient in daily work activities/projects.ENVIRONMENTAL WORKING CONDITIONS
Normal office environment.Some travel within community.PHYSICAL/MENTAL DEMANDS
Requires sitting and standing associated with a normal office environment.Some bending and stretching required.Manual dexterity using a calculator and computer keyboard.#HOP
Read LessHealthcare Outcomes Performance Company is a vertically integrated musculoskeletal outcomes management company. HOPCo manages physician practices, hospital service lines, population health and value-based care programs, and musculoskeletal delivery networks.
HOPCo is the managing partner of Arizona-based entities, CORE Institute, Northern Arizona Orthopaedics, CORE Institute Specialty Hospital, Michigan-based CORE Institute, and Florida-based Southeast Orthopedic Specialists Clinics and Musculoskeletal Specialty Hospital.
As HOPCo continues to grow, we are looking for a Credentialing Specialist to join the Credentialing Team. Please see below for the functions and requirements for this position.
ESSENTIAL FUNCTIONS
Reviews and completes hospital and payor applications for all health care providers.Completes verification forms/letters for outside facilities.Maintain billing insurance grid, provider insurance grid and each individual physician’s spreadsheet up to date on current insurance changes.Track and maintain physician licensure(s), certification and CME credits.Maintain practitioner credentialing files.Maintain practitioner electronic file by keeping all applications/licensure current.Maintains all renewal applications for both hospitals/insurances.Has knowledge of Employee Handbook content along with established policies and procedures.Relies on instructions and pre-established guidelines to perform the functions of the job.Assists the Credentialing Supervisor in their job responsibilities/duties when necessary.EDUCATION
High school diploma/GED or equivalent working knowledge preferred.EXPERIENCE
3-4 years of Credentialing experience.REQUIREMENTS
Must be able to communicate effectively with physicians, providers, licensing agencies, insurance payors and the public and be capable of establishing good working relationships with both internal and external customers.Some knowledge of insurance billing and hospital credentialing a plus.KNOWLEDGE
Knowledge of the credentialing process.Knowledge of computer systems.Knowledge of credentialing paperwork and timelines.Knowledge of credentialing timelines and regulations.SKILLS
Skill in establishing good working relationships with internal and external customers.Skill in organizing daily work assignments for various providers.Skill in managing multiple work assignments and set priorities.ABILITIES
Ability to establish good working relationships with internal and external customers.Ability to communicate effectively with physicians, credentialing agencies and staff.Ability to be organized and efficient in daily work activities/projects.ENVIRONMENTAL WORKING CONDITIONS
Normal office environment.Some travel within community.PHYSICAL/MENTAL DEMANDS
Requires sitting and standing associated with a normal office environment.Some bending and stretching required.Manual dexterity using a calculator and computer keyboard.#HOP
Read Less