Job Requirements
Company’s Ideal Candidate will have the following qualifications:

• Bachelor’s degree with additional substantial healthcare experience and knowledge preferred
• A proven track record of success in business development in the healthcare industry
• Demonstrated ability to recruit, new clients train and manage a sales team, as well as have the ability to motivate a team to achieve outstanding sales success
• Knowledge and experience in Medical Collections and/or other healthcare services involving Appeals & Denials and practice management.
• Knowledge of the payor process to include commercial payer, HMO, PPO, W/C ect…..
• Demonstrated ability to meet or exceed Business Development objectives.
• Excellent negotiating skills and financial acumen
• Excellent verbal and written communication skills
• Compliance with accepted professional standards and practices
• Ability to work in an interdisciplinary setting
• Satisfactory references from employers and/or professional peers
• Valid driver’s license with maintenance of safe driving record and an automobile that is insured in accordance with state and/or company requirements and is in good working order
• Satisfactory criminal background check
• Self-directed with the ability to work with little or no supervision
• Flexible and cooperative in fulfilling all obligations including Ability to work long hours and willingness to Travel as necessary.

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Phone 305-821-4137
FAX 305-819-7564

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Collectors / Reimbursement Specialists
Claims Analyst / Reimbursement Auditor
Director of Operations /Financial Services
Data Entry / Scanning Clerk

Director of Operations / Financial Services
Claims Analyst / Reimbursement Auditor
Experienced Collectors / Reimbursement Specialists
Business Development

The following is a list of professional organizations that Excel is affiliated with.

Participates in resolving intra-departmental and inter-departmental system/process problems. Provides input for resolution of identified problems/concerns. Has the willingness and the ability to perform additional duties and responsibilities in different areas of the department.

Collaborates with appropriate staff in the development of the departmental budget. Variances are explained and action plans completed, as appropriate.

Documentation regarding department and administrative functions is completed timely and appropriately.

Identify areas for staff development and skills training. Schedule and process.

Consistently strives to understand, anticipate and meet the needs, expectations and satisfaction of company, clients, co-workers and Adminitration.

Establishes expectations and plans, sets priorities, and manages processes to measure, systematically assess, and implement improvements to maintain achievements within the department. Compiles, analyzes, and documents data and outcome measurements and submits to the appropriate departments/clients and staff.

Achieve 100% of cash collection goals through the implementation of Companies policies and procedures.

Continually strive to improve the collection process through the following: a) hiring, training and retention of qualified staff; b) implementation/enhancement of bonus program; and c) work closely with third party favors to resolve problems. Work closely with collectors, COLLECTORS / REIMBURSEMENT SPECIALISTS, Claims Analyst / Reimbursement Auditor 16% of Net Patient Revenue.

Achieve Companies goal of 4 days of gross revenue in Placement of accounts.

Achieve 65 days of Net Revenue in A/R,, and then work towards Companies goal of 60 days.

Achieve Companies goals of no more than 30% of accounts aged greater than 90 days and less than 2% of accounts aged over 365 days.

Achieve Companies goal of 2 days gross revenue in credit balances and or adjustments.

Oversee and ensure proper operations of all departments in accordance with Companies policies and procedures.

Provide Monthly analytical reports to Clients and Administration.

Employee must have willingness and ability to perform additional duties in different areas of the department/clients on an as-needed basis. Candidate must also be willing to occasionally work long hours or weekends to complete any projects. Travel for business, as requested.

Communicates well with management, co-workers and clients, reporting problems with equipment, supplies, or procedures.

Consistently strives to understand, anticipate and meet the needs, expectations and satisfaction of our clients, co-workers and Administration.

Establishes expectations and plans, sets priorities, and manages processes to measure, systematically assess, and implement improvements to maintain achievements within the department. Compiles, analyzes, and documents data and outcome measurements and submits to the appropriate departments/clients and staff.

Achieve 100% of cash collection goals through the implementation of Companies policies and procedures.

Continually strive to improve the collection process through the following: a) hiring, training and retention of qualified staff; b) implementation/enhancement of bonus program; and c) work closely with third party favors to resolve problems. Work closely with collectors, COLLECTORS / REIMBURSEMENT SPECIALISTS, Claims Analyst / Reimbursement Auditor 16% of Net Patient Revenue.

Achieve Companies goal of 4 days of gross revenue in Placement of accounts.

Achieve 65 days of Net Revenue in A/R,, and then work towards Companies goal of 60 days.

Achieve Companies goals of no more than 30% of accounts aged greater than 90 days and less than 2% of accounts aged over 365 days.

Achieve Companies goal of 2 days gross revenue in credit balances and or adjustments.

Oversee and ensure proper operations of all departments in accordance with Companies policies and procedures.

Provide Monthly analytical reports to Clients and Administration.

Employee must have willingness and ability to perform additional duties in different areas of the department/clients on an as-needed basis. Travel for business, as requested.

Communicates well with management, co-workers and clients, reporting problems with equipment, supplies, or procedures.

Consistently strives to understand, anticipate and meet the needs, expectations and satisfaction of our clients, co-workers and Administration.

Job Requirements
Bachelor’s Degree required

Five (5) years experience as Business Office Manager or Business Office Director in a hospital or healthcare setting.

Proficiency in Microsoft applications including Outlook, Excel and Word Understanding of HIPPA and its requirements

High school diploma required; Background Check and Drug Screen Required.

Bilingual

Posted on 10/11/2009

• Understand Medical Billing, Denial appeal processes and be able to read and act upon EOB¡¦s Explanation of Benefits (EOB) to determine denial type; understanding of the escalation process.
• Research client data systems to determine current status/past actions on claim;
• Contact insurance companies to verify denial reason;
• Determine appropriate action to resolve denial;
• Ability to navigate through various processing/claims systems/host system in a computer. Basic Microsoft Word applications including Excel.
• Reporting Medicare, Medicaid and third-party payer rejection and or denial ¡§issue¡¨ trend to project supervisor.
• Knowledge of hospital-based billing within last 2 years.
• Knowledge of UB04 Form
• Must be extremely organized and highly motivated and achieve high levels of productivity.

2. Take appropriate action to resolve claim for payment, which includes the following:

• Contact insurance companies/patients to gather necessary information to resolve claim;
• Gather information requested by the insurance company, including medical records and information from clients
• Dropping a new claim for payment;
• Writing a letter of appeal;
• Requesting an adjustment;
• Transferring balance to patient liability.

3. Provide excellent customer service, including timely response to telephone calls, e-mails, and other verbal or written correspondence.

4. Travel for business, as requested.

5. Seek technical assistance by notifying the immediate supervisor of problems/issues related to collections, accounts, employees, clients, or others, as necessary and appropriate.

6. Provide technical assistance to co-workers and/or clients as requested, including providing assistance/instruction to achieve task completion.

7. Compose and proof correspondence, including e-mail, letters, and other written documents.

8. Attend staff and other professional meetings, including technical or professional classes, workshop or seminars to exchange information and improve technical or professional skills.

9. Employee has willingness and ability to perform additional duties in different areas of the department/hospital on an as-needed basis. Candidate must also be willing to occasionally work long hours or weekends to complete any projects.

Requirements
Minimum 3-5 years experience in Hospital – Patient Financial Services Department providing insurance collections and follow-up and denied claims duties preferred

UB04 Claim Form experience Ability to read and understand and act upon EOB information Analytical and Detail Oriented Experience in Siemens Invision, AS400, IDX Flowcast, Eclipsys, ePremis, DDE, CareMedic’s eFR applications (a plus)

Bilingual

Proficiency in Microsoft applications including Outlook, Excel and Word Understanding of HIPPA and its requirements

High school diploma required; Background Check and Drug Screen Required.

Posted on 10/11/2009

• Read contracts and calculate reimbursements.
• Effectively collect or resolve patient accounts receivable and monitor hospital A/R including aging accrual, write-off’s, and transfers to bad debt.
• Resolves patient accounts by collecting payment and/or by contractual adjustment by obtaining insurance and/or third party information.
• Keeps insurance employees updated on specific insurance handling of specific client(s).
• Responsible for checking status and documenting all assigned insurance accounts and submitting claims for billing or rebilling electronically or hard copy.
• Hours: 8:00 – 5:00

Requirements:

Must have previous managed care experience and be able to pass a managed care test.
3-5 years of hospital billing/collection managed care experience.

• Knowledge of claims review and analysis.
• 3-5 yrs Knowledge of Medicare and Managed Care payers.
• HMO/PPO, Workers Compensation and Self Pay accounts experience.
• Strong oral and written communication skills.
• Self-directed and capable of working without direct supervision.
• Intermediate knowledge of Microsoft Word and Excel; and the ability to learn new programs and systems.
• Writing a letter of appeal
• Strong analytical skills and attention to detail.
• Ability to work well with others.
• Dependable in both production and attendance.
• Ability to work well under deadline constraints.
• Phone skills — as phone usage is high.
• Travel for business, as requested.
• High school diploma required
• Be an employee in good standing in terms of your overall work record, and
• Have been in your current position, generally, for a minimum of one (1) year.
• Will be subject to a criminal background check and drug test.
• Candidate must also be willing to occasionally work long hours or weekends to complete any projects.
• Bilingual

Posted on 10/11/2009

Privacy Policy
Your privacy is vitally important to us. Excel HealthCare Receivable Management & Consulting Corp. (“EXCEL”) does not presently collect personal information (”your information”) except as follows: (1) your web browser or ISP may give information to our web server such as your e-mail address; (2) you may provide your information to us in an e-mail message; and (3) you may provide your information to us to request information from us, such as when you submit a request for information through our site. We will not provide your Information to any third party without your permission.
Please be advised that although EXCEL has taken all security precautions the internet is not a totally secure forum for the exchange of information, and we cannot ensure the security and privacy of any email sent to EXCEL through this site.
Your use of EXCEL’S website indicates your consent to the collection and use of your information as outlined in this Privacy Policy. EXCEL may change its Privacy Policy at any time by posting a new Privacy Policy on this site.

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This website and the content contained herein are owned and operated by Excel HealthCare Receivable Management & Consulting Corp and are protected by applicable law. All trademarks, service marks, product names, or company names which may appear on this website are the property of their respective owners.

HIPPA COMPLIANT
The Health Insurance Portability and Accountability Act of 1996 (HIPAA) is a federal law that takes its name from provisions allowing workers and their families to continue their health insurance when they change or lose their jobs (portability) while strengthening enforcement of federal laws against healthcare fraud (accountability).
It also provides a method of making business practices (billing, Collection, claims, computer systems, and communication) uniform so that providers and payers can more easily exchange information and work with one another (administrative simplification).
The purpose of HIPAA’s privacy requirements is to:

• Restrict the unwarranted disclosure of patient health information (PHI).
• Give patients greater control over access to their personal health information, including specific information that can be disclosed, to whom, and for what purpose it may be used.
• Enable providers to use the patient’s health information to provide services to meet their obligation to the patient and regulatory and law enforcement agencies. Protected Health Information (PHI) is defined as individually identifiable health information that is transmitted or maintained in any form or medium (written, electronic, recorded and spoken) by covered entities or their contractors. PHI relates to past, present or future medical or mental condition of the patient; the provision of healthcare and treatment to the patient and; past, present or future submission of claims for treatment. Health information becomes “protected” when it is combined with any piece of information that could identify who that person is. Examples of health information include conversations between physicians, images, written records, insurance information, and demographics. HIPAA does not protect health information located in personnel records, or at federally funded schools or colleges. Excluded from the definition of covered information is health information that has been “de-identified” by removing, redacting, coding, encrypting or otherwise eliminating or concealing all individually identifiable information.

“The federal privacy regulation empowers patients by guaranteeing them access to their medical records, giving them more control over how their protected health information is used and disclosed, and providing a clear avenue of recourse if their medical privacy is compromised.” (Department of Health & Human Services News Release, August 9, 2002)

RED FLAG
Claim denied as procedure not covered under contract. Excel resubmitted claim w/ supporting agreement documentation between hospital and insurance. Excel forward appeal package Claim reprocessed and additional payment was issued

Excel has implemented policy & procedures and system processes to meet the Guidelines established by Fair and Accurate Credit Transactions (FACT) Act of 2003 “RED FLAG”.

Financial institutions and creditors are now required to develop and implement written identity theft prevention programs under the new “Red Flags Rules.” The Red Flags Rules are part of the Fair and Accurate Credit Transactions (FACT) Act of 2003. Under these Rules, financial institutions and creditors with covered accounts must have identity theft prevention programs in place by November 1, 2008, to identify, detect, and respond to patterns, practices, or specific activities that could indicate identity theft. The Commission staff is launching an outreach effort to explain the Rules in greater detail. It has now published a general alert on what the Rules require, and, in particular, an explanation of which businesses – financial institutions and creditors – are covered by the Rules.

To learn more, go to http://www.ftc.gov/bcp/edu/pubs/business/alerts/alt050.shtm