QualDerm Partners

Role Description The Credentialing Specialist is responsible for overseeing all aspects of the credentialing, re-credentialing, payer enrollment, and privileging processes for all providers in an assigned region. The Credentialing Specialist will develop strong relationships with regional operational leaders to ensure proactive communication on credentialing and recredentialing requirements while ensuring that credentialing is complete in advance of services being rendered under contracted and enrolled health plans. The Credentialing Specialist will be responsible for implementing standardized processes and capturing data for each provider in QualDerm's credentialing databases and online systems for utilization across multiple stakeholder groups. Essential Duties and Responsibilities - Oversee all aspects of Provider Credentialing and Payer Enrollment with third party payers and hospital/health system partners for assigned region. - Assure compliance with all health plan requirements as related to provider certification and credentialing. - Meet with assigned region operational leadership on a routine basis to ensure timely onboarding of new providers and that all credentialing needs are met. - Manage processes that maintain up-to-date data for each provider in credentialing databases and online systems. - Ensure timely renewal of licenses, certifications, and credentialing. - Maintain confidentiality of provider information. - Assist in managing the flow of information between payers, contracted PHOs, ACOs, and other QualDerm networks. - Coordinate and prepare management reports for assigned regions. - Manage continual process and quality improvement efforts related to payer enrollment, data entry, credentialing committees, and all aspects related to credentialing & enrollment. - Participate in the training of new Credentialing & Enrollment team members. Qualifications - Bachelor’s degree in related field preferred. - Minimum of three (3) years’ experience in managed care credentialing or medical staff service setting required. - National or multi-state credentialing experience preferred. - Demonstrated skills in analysis, problem solving, and resolution. - Ability to communicate appropriately and effectively with practitioners and providers, including sensitive and confidential information. - Strong knowledge of NCQA, Joint Commission, URAC, CMS, and State Laws and regulations as they pertain to the credentialing of QualDerm providers. - Prioritize and meet deadlines on an ongoing basis to ensure timely completion according to process requirements. - Must be able to function independently in a matrix environment. Benefits - Competitive Pay – Attractive compensation to reward your hard work. - Comprehensive Health Coverage – Includes Medical, Dental, and Vision plans to keep you covered. - Generous 401(k) Plan – Company matches 100% of the first 3%, plus 50% of the next 2%, with immediate vesting. - Paid Time Off (PTO) – Accrue PTO from day one, plus enjoy 6 paid holidays and 2 floating holidays each year. - Company-Paid Life Insurance – Peace of mind with basic life coverage, with the option for additional plans. - Disability Protection – Short-term and long-term disability coverage to protect you in unexpected circumstances. - Additional Wellness Plans – Accident, critical illness, and identity theft protection plans for extra security. - Employee Assistance Program (EAP) – Access confidential support for personal or work-related challenges. - Exclusive Employee Discounts – Save on products and services with special discounts just for you. - Referral Bonus Program – Earn bonuses by referring qualified candidates to join the team. Company Description QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S., with 150+ locations in 17 states. We are united in our purpose: to educate, protect, and care for your skin. Our mission is to educate communities and healthcare professionals about the importance of skin health, including skin cancer prevention and how to achieve healthy skin through annual skin exams and dermatologic care.

Role Description We are currently seeking a highly disciplined, self-motivated Remote Central Scheduling Specialist to support a fast-paced group of dermatology practices. This role is ideal for someone who thrives in a high call volume environment, follows strict schedules, and requires minimal supervision to stay productive and focused throughout the day. - Remote Position: Candidates must reside within a reasonable driving distance of Lombard, IL. - Hours Scheduled: Mon-Thurs 9:30am-6pm / Fridays 8am-5pm - This is not a casual remote role — success in this position requires strong time management, reliability, and the ability to stay engaged during continuous inbound and outbound calls. - Make an impact: Working together we can ensure the best possible relationship and care for our patients. - Learn and grow: We’re committed to growing the capabilities of our people. Qualifications - Minimum of 1 year medical insurance verification experience required. - High School Diploma required; Associate's Degree preferred. - Minimum of 1 year customer service experience in a healthcare setting preferred. - Strong communication and interpersonal skills. - Ability to manage multiple tasks efficiently in a fast-paced environment. - Proficiency in scheduling software and Microsoft Office applications. - Understanding of HIPAA regulations is a plus. Benefits - Retirement Plans - Medical, Dental and Vision Coverage, for full-time staff - Paid Time Off - Paid holidays - Competitive Salary Company Description QualDerm Partners, LLC is proud to be an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees. Compensation Range: $17.00 - 19.50 per hour. Final offer will be based on a combination of skills, experience, location, and internal equity.

• The RCM Reporting and Analytics Specialist is responsible for establishing revenue cycle performance reports and analytics on functional performance, key performance indicators and other metrics. • Prepares ad hoc reports as requested by the Vice President of Revenue Cycle or other organizational leaders. • Prepare quarterly, monthly, and weekly reports as required by Revenue Cycle Leadership. • Identifies performance trends and opportunities related to revenue cycle performance, efficiency and automation, including but not limited to monitoring of Revenue Cycle systems, identifying root cause, documenting processes and related issues, and recommending improvements, and participating in and/or leading improvement initiatives. • Perform analysis to trend and to identify RCM impacting factors and provide clear explanations of meaningful variances to operations and management. • Prepare ad-hoc analysis for management, physicians, and investors as needed. • Prepare reports and presentations as requested by RCM leadership. • Analyze and report on the effects of proposed federal and state statutes and regulatory actions that may impact long term financial planning. • Collaborate with other departments to transform data and metrics into digestible and actionable presentation materials. • Communicate with all team members in a courteous, professional, cooperative, and mature manner. • Treats staff, physicians, visitors, and patients with dignity and respect. • Adheres to Code of Conduct and Mission & Value Statement. • Participates in special projects as needed.

• Serves as first point of contact for incoming billing customer service calls. • Provides optimum customer service, including quality assurance, for all patient inquiries. • Answer high-volume incoming communications from customers/patients. • Returns all phone messages within 24 hours of receipt. • Must be able to deal diplomatically with complaints and function well under pressure. • Utilize resources and conduct research to troubleshoot and resolve patient issues. • Reviews patient account data when interacting with patients to ensure that accurate information regarding patients’ insurance and demographic information are correctly reflected on the patient’s account. • Updates insurance and demographic information as necessary on patient accounts. • Accurately documents patient accounts of all actions taken. • Set up payment plans and take credit card payments over the phone. • Effectively uses billing system to document patient accounts using proper grammar, spelling, and syntax. • Participates in special projects as needed. • Maintains regular and predictable attendance. • Adheres to Code of Conduct and Mission & Value Statement. • In addition to the above job responsibilities, other duties maybe assigned.

With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners, we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you! Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees. Position Summary This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome. This position completes tasks associated with posting, adjusting, and monitoring patient accounts receivables. Position proactively researches, identifies, and rectifies any circumstance affecting delayed submission or payment of accounts. Position communicates accounts receivable issues proactively to management to ensure compliance and accuracy. Position performs various administrative and clerical duties needed to support revenue cycle functions as needed. Position reports to the Supervisor, Payment Posting and/or Director, Cash Management. Essential Responsibilities - Reconciles bank deposit daily. Uses daily bank deposit to verify all deposited amounts are in the clearing house or on a paper remit to be posted. - Effectively lead and oversee the Payment Posting Team for your assigned region. - Review and monitor workflows to manage and maintain an efficient cash application process. - Provide new hire training and continuing education for your team. - Meets productivity requirements as established by organization and external benchmarks - Assist in the identification and correction of posting errors. - Run reports as requested or required by management. - Completes posting of all payments and adjustments at the patient account level in a timely and accurate manner. - Ensures completion of End of Month Closing activities - Proactively engages other operational personnel to review and resolve issues as needed. - Participate in team meetings and provide assistance and coaching to other team members. - Provide day-to-day support to the team as well as management, including backup in all functions of the department when needed. - Ensure all lockbox files are received on a regular and timely basis. - Review outstanding account balances for collections. - Assist in setting up Electronic Remittance Advices (ERA) and Electronic Funds Transfers (EFT) for Commercial and Medicare payors. - Effectively uses billing system to document patient accounts using proper grammar, spelling, and syntax. - Adheres to Code of Conduct and Mission & Value Statement.

With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm Partners, we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you! Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees. Position Summary This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome. This position completes tasks associated with posting, adjusting, and monitoring patient accounts receivables. Position proactively researches, identifies, and rectifies any circumstance affecting delayed submission or payment of accounts. Position communicates accounts receivable issues proactively to management to ensure compliance and accuracy. Position performs various administrative and clerical duties needed to support revenue cycle functions as needed. Position reports to the Supervisor, Payment Posting and/or Director, Cash Management. Essential Responsibilities - Completes posting of all payments and adjustments at the patient account level in a timely and accurate manner, balancing to the bank deposit daily. - Contact patients, insurance or third-party administrators when clarification of information is needed to successfully post payment. - Call, chat, email insurances to resolve payments/offset questions - Check websites for additional information to resolve payments/offset issues - Work on recoupment accounts to resolution. - Research and resolve insurance overpayments and credits. - Processes patient refund requests and manages refund register. - Assists with monthly close functions including month end balancing. - Review all remittance advices for accuracy to identify errors or questionable data. Manages time to complete work in timely manner and be a team player. - Meets productivity requirements as established by organization and external benchmarks. - Proactively engages other operational personnel to review and resolve issues as needed. - Provides professional assistance for patient billing calls. - Keep up-to-date with current with payer guidelines and reimbursement policies (basic knowledge). - Effectively uses billing system to document patient accounts using proper grammar, spelling, and syntax. - Adheres to Code of Conduct and Mission & Value Statement.

With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you!  Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. Purpose: This position works with a professional team of physicians and other staff who are trained in the medical and surgical specialty of dermatology with the purpose to be patient focused with the objective of delivering superior patient care and ensuring a positive patient experience and outcome. The position serves patients and visitors by answering phones, assisting patients with registration and intake, scheduling appointments and taking payments over the phone and in person. This position is supervised by the Lead, Customer Service and/or Manager, Customer Service. Essential Duties and Responsibilities: - Serves as first point of contact for incoming billing customer service calls. - Provides optimum customer service, including quality assurance, for all patient inquiries. - Answer high-volume incoming communications from customers/patients. - Returns all phone messages within 24 hours of receipt. - Must be able to deal diplomatically with complaints and function well under pressure. - Utilize resources and conduct research to troubleshoot and resolve patient issues. - Reviews patient account data when interacting with patients to ensure that accurate information regarding patients’ insurance and demographic information are correctly reflected on the patient’s account. - Updates insurance and demographic information as necessary on patient accounts. - Accurately documents patient accounts of all actions taken. - Set up payment plans and take credit card payments over the phone. - Effectively uses billing system to document patient accounts using proper grammar, spelling, and syntax. - Participates in special projects as needed. - Maintains regular and predictable attendance. - Adheres to Code of Conduct and Mission & Value Statement. - In addition to the above job responsibilities, other duties maybe assigned.

Fully remote position; requires availability during standard East Coast (ET) business hours. With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you!  Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees. Not only do we offer aggressive compensation and benefit packages, but we offer a culture that is unsurpassed! Purpose: The purpose of a Triage Specialist is to perform effective telephone triage to support dermatology patients based on their needs. Essential Duties and Responsibilities: - Answer phones/returning voicemails to handle all questions and/or transfer accordingly. - Understand and relay stat emergent situations, pathology results, navigate EMA/EMR-faxes, tasks, general knowledge. - Relay pathology results including biopsies, scheduling returns and minor procedures. - New patient scheduling, making charts and notes. - Answer questions to patient’s satisfaction using basic medical terminology and understanding. - Document all conversations appropriately in EMA. - Schedule various surgeries in template according to provider specific needs and guidelines. - Prioritize skin cancers based on type, subtype, size, location and aggressive nature. - Explain Mohs procedures to patients – what to expect. - Perform and complete pre-op assessments and send in required antibiotics or other medications, if necessary, under the guidelines set by providers.

Fully remote position; requires availability during standard East Coast (ET) business hours. With 150+ locations in 17 states, QualDerm Partners is the largest multi-state female-founded and owned dermatology network in the U.S. At QualDerm we are united in our purpose: to educate, protect, and care for your skin. We are committed to bringing you the very best in comprehensive skin care so that you can achieve a confident, healthier, and more beautiful you!  Our mission is to educate communities and healthcare professionals about the importance of skin health; including skin cancer prevention, risk factors and how to achieve healthy skin through annual skin exams and dermatologic care. We strive to provide the latest proven, proactive and comprehensive dermatologic care to populations in the expanding geographies we serve by making high-quality skin care timelier and more accessible all while creating a rewarding work environment for our providers and employees. Not only do we offer aggressive compensation and benefit packages, but we offer a culture that is unsurpassed! Purpose: The purpose of a Triage Specialist is to perform effective telephone triage to support dermatology patients based on their needs. Essential Duties and Responsibilities: - Answer phones/returning voicemails to handle all questions and/or transfer accordingly. - Understand and relay stat emergent situations, pathology results, navigate EMA/EMR-faxes, tasks, general knowledge. - Relay pathology results including biopsies, scheduling returns and minor procedures. - New patient scheduling, making charts and notes. - Answer questions to patient’s satisfaction using basic medical terminology and understanding. - Document all conversations appropriately in EMA. - Schedule various surgeries in template according to provider specific needs and guidelines. - Prioritize skin cancers based on type, subtype, size, location and aggressive nature. - Explain Mohs procedures to patients – what to expect. - Perform and complete pre-op assessments and send in required antibiotics or other medications, if necessary, under the guidelines set by providers.

• Ability to identify the cause of claim denials and resolve them, with minimal assistance. • Analyze problems and report trends related to denials and payer trends. • Follow up on unpaid claims within standard billing cycle timeframe. • Prepare and submit corrected/replacement claims, reconsiderations, appeals, medical documentation and other necessary documents to payers via fax, provider portals, etc. • Make outbound calls to payers to resolve claims and payment issues. • Ensure the patient’s medical information is accurate and up to date. • Meets productivity requirements as established by organization and external benchmarks. • Provides necessary reporting and communication of any accounts receivable issues directly to the team lead. • Effectively uses billing system to document patient accounts using proper grammar, spelling, and syntax. • Provide team lead with administrative assistance when needed including assisting with internal/external audits. • Maintains current knowledge in regards policies and guidelines for all payers. • Adheres to Code of Conduct and Mission & Values Statement. • In addition to the above job responsibilities, other duties and projects may be assigned