Job Description

Description:

About Providence Anesthesiology Associates

Headquartered in Charlotte, North Carolina, Providence Anesthesiology Associates (PAA) is an independent physician owned practice compromised of over 100 anesthesiologists. Founded in 1991, PAA provides anesthesia and perioperative care at numerous healthcare facilities throughout North and South Carolina, serving more than 150,000 patients annually.

Why work for PAA?

PAA continues to experience impressive growth and success. Our anesthesiologists are among the most elite in their field.

Our physicians are committed to providing the best culture and experience to their employees. Awarded one of the Top Workplaces in 2021, PAA\'s core values include commitment, accountability, performance, integrity, transparency, adaptability, and leadership. We do what\'s right and don\'t compromise.

What\'s in it for you?

• Strong workplace culture. We care about each other as people. We build relationships and connections beyond the time spent on the job. We offer a supportive, highly team-oriented work environment.
• We provide competitive total rewards including salary, benefits \xe2\x80\x93 Day 1, retirement, profit sharing, life insurance, paid time off, holidays, education reimbursement, employee recognition for birthdays and anniversaries, fun team building events, and more.
• We want you to succeed and our employer to employee relationship is proven to help you reach your goals and the goals of PAA.

Summary: The Payor Relations Representative will assist in reviewing claims and Explanation of Benefits (EOBs) for accuracy and ensure payments and adjustments on patient accounts match accordingly. The Payor Relations Representative is also responsible for assisting patients with billing inquiries via telephone and reviewing patient accounts. A person in this role should be prepared to correct adjustments as needed and submit information via online forms pertaining to arbitration and plan under-payments. This role requires an analytical mindset, organizational skills, effective communication, and great attention to detail.

*Hybrid Position - Combination of working in an on-site evironment and remotely

Requirements:

Essential Duties and Responsibilities

• Duties include but are not limited to:
• Answer inbound calls from patients who have an insurance plan that is out-of-network with Providence Anesthesiology Associates and assist with account inquiries. Assess patient accounts, perform account maintenance, and follow up with patients after completing more in-depth reviews when necessary.
• Analyze out-of-network claims for compliance with the No Surprise Billing Act.
• Compiling and submitting data via Microsoft Excel and online portals for claims eligible for out-of-network Independent Dispute Resolution (IDR).
• Review Explanation of Benefits (EOBs) and adjust the patient\'s account when required.
• Data entry and attaching documentation to patient files.
• Verify eligibility with patients to determine insurance coverage.
• Processes credit card transactions from patients via phone.
• Ensure compliance with all Health Insurance Portability and Accountability Act (HIPAA) standards.
• Perform other duties as required or assigned within the scope of responsibility.

Minimum Qualifications

To perform this job successfully an individual must be able to perform each essential duty to a satisfactory standard. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education: High School Diploma or equivalent required. Associates degree or medical billing education preferred.

Experience: One (1) year of customer service experience in a medical billing environment is required. One (1) year of Accounts Receivable and the ability to understand and analyze complex AR resolutions is highly preferred.

Language Skills: Demonstrated ability to exercise professional oral and written communication skills with all internal and external audiences.

Computer Skills: Experience with medical billing software systems is preferable along with Microsoft Excel, Microsoft Outlook, Word, and PowerPoint proficiency.

Reasoning Ability: Ability to organize and manage personal workload and the workload of assigned direct reports and associated teams. Ability to achieve and maintain strong working knowledge of anesthesia billing operation practices. Ability to analyze and assess the production effort of operations teams. Ability to work within an ambiguous, fast-moving environment, while driving toward clarity and solutions. Ability to make consider possible solutions and make decisions quickly. Ability to develop and execute corrective action plans

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by any employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to sit, stand, walk, use hands to finger, handle, or feel, reach with hands and arms, and talk or hear. The employee is occasionally required to stoop, kneel, crouch, or crawl. The employee must occasionally be able to work in a standing position for short periods of time.

What else should you know?

Providence Anesthesiology Associates is an equal opportunity employer and does not tolerate discrimination based on any protected status.

PAA participates in E-Verify. E-Verify is an internet-based system that compares the information you provide on the Form I-9 with information from the Social Security Administration and Department of Homeland Security records.

PAA Strong!

PI222812023

Providence