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TYPE OF WORK
Full Time
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SALARY
1100-1800
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HOURS PER WEEK
40
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DATE UPDATED
Dec 27, 2024
Hello prospective future tea
Thank you for your interest in Timothy Groth MD PC. We are a out patient pain management and chiropractic practice based in Long Island NY. We serve patients in the community who have Medicare, WC, NF, and commercial insurances including Healthfirst, Fidelis, BCBS, Aetna, UHC, Cigna, Emblem, GHI, Magnacare, and more. Since 2020 we have worked with people in the Philippines directly hired by our practice. We currently have a team of about 15 people in the Philippines helping with all different aspects of the practice. Many of our tea
1. Ability to document accounts proficiently in an EHR and the information that is needed for clear understanding.
2. Proficiency in the Appeal process and what is needed to get a claim paid.
3. Senior level understanding of claim follow up and attention to details
4. Investigate denied claims in its entirety and a clear understanding as to why claim was denied.
5. Work all denials that pertain to but not limited to, Duplicate Claim, Timely Filing, EOB requests, Not Medically necessary denials, COB denials.
6. Responsible for reviewing denial trends, identifying the root cause and escalating to Management .
7. Provide feedback on how to improve current processes to eliminate future denial occurrence.
8. . Have a Sr. level understanding of the corrected claim process and when a claim should be corrected and what is needed for this process.
9. Proficient in LCD/Modifier/DX /CPT combination and when it is needed.
10. Proficient in navigation on provider portals.
11. Clear understanding in Medicare and Commercial guidelines.
12. Understanding directives and adhering to SOP (Standard Operating Procedures) in the practice.
14. Responsible for maintaining a daily account review of above 25 accounts (subject to change).
15. Strong Follow up experience required
16. Pain Management experience a plus
