Role Description Bring your passion to Texas Health so we are Better + Together - Direct staff on work assignments to ensure all work queues are worked timely and efficiently. Step in as needed to help clear work queues. - Assists in monitoring charge review, charge edit and PCR/Denial work queues to ensure compliance with established guidelines. Maintains records to record/track discrepancies. Assist leadership in conducting follow-up on identified discrepancy/issues and root cause analysis to prevent systematic recurrence of issues. - Serves as a subject matter expert, providing direction to less experienced staff. Assists with training, auditing of work, and provides feedback on opportunities for improvement. Assist leadership in ensuring productivity standards are consistently met. - Assists less experienced staff in resolving more complex and/or escalated patient billing inquiries and problems, handling follow-up questions from patients, resolving discrepancies or errors. Acts as a liaison with Practice Managers to obtain necessary information and resolve reconciliation discrepancies. - Audits denials and write-offs looking for trends and educates staff as appropriate. - Perform other duties as assigned. Qualifications - H.S. Diploma or Equivalent - 5 Years Billing experience in a health care environment. - CPC - Certified Professional Coder Upon Hire (Preferred) Requirements - Knowledge of third party billing regulations and third party payer requirements. - Working knowledge of industry standard medical coding conventions. - Must be detail oriented and have strong organization skills, and communication skills. - Proficient computer skills. - Possess a strong work ethic and a high level of professionalism. - Must be a dependable self-starter and be deadline driven. - Must have the ability to work well independently and in a team setting to meet organizational goals. Company Description Texas Health Physicians Group (THPG) is a not-for-profit physician organization with more than 250 locations and 800 physicians, nurse practitioners and physician assistants dedicated to providing quality care in clinics and medical offices throughout North Texas.

Role Description Immediate need for an Sr. Billing Specialist to join our team. The Sr. Billing Specialist will be a critical player in achieving efficient pre-sale, bookings, and financial operations across the organization. The role reports to the Manager, Billing and Collections. - Track client invoicing preferences and build streamlined processes for the receipt, processing, and communication of invoicing information. - Work with accounting team to route invoicing requests, provide relevant information, and clarify request follow-ups. - Communicate request status, provide relevant information, and answer questions for internal and external requestors. - Monitor multiple billing inboxes, responding to clients in a timely manner. - Recordkeeping: - Enter relevant billing information and documentation into AdBook (revenue tracking system), NetSuite (ERP), and other program tracking platforms. - Assist in the setup, maintenance, and information transfer to and from various invoicing portals, like Ariba, Coupa, etc. - Work with internal and external stakeholders to complete, review, and approve billing documents and vendor forms. - Providing W9s and other vendor requested data. - Maintain a repository of tools, resources, and templates that allow for an accurate and prompt billing and finance workflow on a daily, weekly and monthly basis. Examples include our training guides, information ‘cheat sheets’, and contact sheets when collaboration is required. - Work with accounting team to establish timelines for monthly close process milestones. - Create Adbook reports to be used by and to gather delivery feedback from various internal teams. - Fill out billing information for all active programs within a given month. - Reconcile Adbook data for select programs/clients to ensure billable totals and delivered totals are correct. Qualifications - Bachelor’s degree in a related field with minimum 3+ years work or internship experience. - Strong organizational habits, attention to detail, clear communication, eagerness to learn, and a strong work ethic. - An engaged learner, critical thinker and acute listener. - Microsoft Excel proficiency, Netsuite experience required. Company Description Summit Federal Services, LLC is an equal opportunity employer regardless of race, color, religion, creed, sex, marital status, national origin, disability, age, veteran status, on-the-job injury, sexual orientation, political affiliation or belief. Employment decisions are made without consideration of these or any other factors that employers are prohibited by law from considering. Any discriminatory action can be a cause for disciplinary action. Summit Federal Services, LLC also prohibits discrimination against individuals with disabilities and will reasonably accommodate applicants with a disability, upon request, and will also ensure reasonable accommodation for employees with a disability.

Inspire health. Serve with compassion. Be the difference. Job Summary Performs tasks of moderate to difficult complexity relating to both hospital and physician accounts. Handles a large volume of inbound calls assisting patients with requests for information, complaints, and resolving issues. Responsible for making outbound calls related to self-pay follow-up on accounts. Responsible for data analysis and interpretation throughout all functions of revenue cycle, to determine reasons for denials, non-payment and overpayment, post/balance/correct electronic remittances, billing and follow-up of government payers and specialized accounts, analysis/correction of correct coding guidelines, preparation of accounts for appeal, review/analysis of insurance credit balances, and analysis/movement of unapplied, unidentified, and undistributed balances. Essential Functions - All team members are expected to be knowledgeable and compliant with Prisma Health's purpose: Inspire health. Serve with compassion. Be the difference. - Resolves billing concerns, addresses inquiries related to insurance concerns/matters, assist patients with MyChart while simultaneously establishing a rapport with our diverse field of patients. Reviews accounts to determine insurance coverage; obtains and corrects any missing or inaccurate information. Discusses patient responsibility, which includes educating patients on claim processing, deductible, coinsurance, and co-pays. Interacts with patients by making patients aware of payment options such as payment plans and financial assistance as well as how to apply for financial assistance if circumstance warrant. Ability to set up payment plans in MyChart based on patient's personal needs. - Greets patients in a professional and courteous manner. Communicates clearly and professionally in both oral and written communication. Be clear and concise in all communication to ensure patients understand the information that is being communicated to them by the Customer Service Specialist. Maintains a high level of poise and professionalism in dealing with patients. Knows when to escalate a patient service issue real time. Research customer requests or issues, determines if further action is needed, forwards to appropriate party for resolution, and exercises good judgement to determine urgency of patient's need. - Contacts payer and makes hard inquiries on account status if needed. Escalates problem accounts to the appropriate area(s). Documents billing activity on a patient's accounts according to departmental guidelines; ensures compliance with all applicable billing regulations and reports any suspected compliance issues to departmental leaders. Properly documents accounts clearly with indicators and activities so that tracking and trending can be prepared for any potential further analysis if needed. - Ensures all work is compliant with privacy, HIPAA, and regulatory requirements. - Participates in general or special assignments and attends all required training. Adheres to policies and procedures as required by Prisma Health and follows all compliant regulatory payer guidance. - Answers all incoming calls from Prisma Health patients - Performs other duties as assigned. Supervisory/Management Responsibilities - This is a non-management job that will report to a supervisor, manager, director, or executive. Minimum Requirements - Education - High School diploma or equivalent OR post-high school diploma / highest degree earned - Experience - Two (2) years billing, bookkeeping, and/or accounting experience In Lieu Of - NA Required Certifications, Registrations, Licenses - NA Knowledge, Skills and Abilities - Knowledgeable of the job functions required for a A/R Follow-up Representative, Cash Posting Representative, Claims Clearinghouse Representative, Correspondence Representative, Credit Processing Specialist, Denial/Appeals Specialist, Payment Research Specialist and a Quality Assurance Specialist. - Knowledgeable of the entire Revenue Cycle and Epic. Work Shift Day (United States of America) Location Patewood Outpt Ctr/Med Offices Facility 7001 Corporate Department 70019935 System Billing Office Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.

****This is a fully remote role**** If you are currently employed at Vivent Health, please log into UKG and submit your application through the My Company/View Opportunities page. Get ready for something amazing! Imagine this: generous paid time off, including 12 paid holidays. And that’s just the start of the incredible perks you’ll enjoy at Vivent Health. There is 401k with 100% employer match up to 5%, 12 weeks of fully paid parental leave, employer subsidized medical, dental, vision benefits, and gender-affirming care benefits. And that's not even scratching the surface. Our complete package also includes employer paid short and long-term disability, tuition reimbursement, certification, and licensure assistance, and so much more. We also offer benefits for part-time roles! But here's the real deal. Your journey with Vivent Health isn't just a job. It's a chance to join an organization dedicated to fostering a workforce that reflects diverse backgrounds, perspectives, and experiences. This makes you a part of something bigger and enables you to have a meaningful impact in our communities and the lives of the amazing patients we serve. Here are a few highlights of what working at Vivent Health may offer you: - Equity Practices: Fair treatment, access, and opportunities for all employees, creating an environment where everyone feels valued, respected, and empowered to contribute. - Professional Growth: Opportunities for professional development and advancement, along with training programs and events that promote cultural competence, unconscious bias training, and awareness. - Collaboration on an inter-disciplinary team: Within our integrated HIV care and prevention model, we employ a high level of collaboration across disciplines. That means that, in your role, you will have the opportunity to be exposed to whole person-care across medical, behavioral health, pharmaceutical, research, and more! - Delivery of quality patient care: Our integrated HIV care and prevention model is proven to help patients achieve positive health outcomes. YOUR CONTRIBUTION: Deliver Excellence. Oversee with Integrity. Drive Progress. Exceed Expectations. The Billing Specialist plays an integral role in our growing Healthcare Revenue team. This person is goal-oriented, compliant, revenue-driven, highly organized/accurate and motivated employee. This person is focused on all areas of the revenue cycle for specific Vivent Health Clinics and Departments. OUR EXPECTATIONS: Winning skills and behaviors for success. Essential Job Duties - Review medical records and assign appropriate diagnosis and procedure codes based on guidelines. - Efficient and timely Revenue Cycle work within EPIC including: Charge Review, Claim Edit, Payment Posting, AR Follow-up, Refunds, Patient Support, and Billing Performance vs. Budget. - The Billing Specialist works closely with the Clinic Department Manager, Health Services Administrator, Patient Services Representatives, Coders, EPIC Site Specialist and Vendors (Resolute Analyst, Contracting and Provider Enrollment) to ensure the entire Revenue Cycle is managed well. - Monitor and follow up on outstanding claims, denials, and appeals to resolve billing discrepancies and ensure maximum reimbursement. - Prepare and maintain billing reports, metrics, and documentation to track billing activities, revenue trends, and collections performance. - Meet and exceed patient satisfaction expectations and goals aligned with Vivent health mission. - Special Department or payer projects. - Assist with payment posting, credentialing projects, fee schedule analysis and additional projects that support the Healthcare revenue cycle department. - Other duties as assigned. - Adhere to all agency policies, including but not limited to Confidentiality, Employee Handbook, Health Care Corporate Compliance Plan, Standards of Conduct, training, and other relevant policies. NOTE: Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions. KNOWLEDGE REQUIRED: Required and preferred knowledge and experiences to succeed. - Education: - High school diploma or equivalent. Associates degree preferred. - Work Experience: - Minimum of 2-3 years of experience in medical billing or healthcare revenue cycle management, preferably in a clinic or healthcare setting. - Technical Experience: - Proficiency in EPIC Resolute Billing. - Excellent experience with Microsoft Office applications. - Experience with CPT and ICD-10 coding; familiarity with medical terminology. - Experience in filing claim appeals with insurance companies to ensure compliant, maximum reimbursement. - Soft Skills: - Excellent customer service skills. - Strong written and verbal communication skills. - Meticulous attention to detail in reviewing billing codes, claims, and payments to ensure accuracy and compliance. - Strong analytical skills to identify trends, and address billing issues effectively. - Ability to manage relationships with various Insurance payers, including Credentialing Managers and Regional payer representatives. - Understanding of HIPAA compliance and responsible use of confidential information. - Ability to handle multiple projects and work courteously and respectfully with fellow employees, clients and patients. - Effective problem-solving skills and can-do attitude to resolve billing discrepancies, denials, and appeals in a timely manner. - Commitment to staying updated on industry trends, regulations, and best practices in medical billing and revenue cycle management. - Additional Preferred Qualifications: - HIV experience in a not-for-profit environment. STATEMENT OF INCLUSION: Vivent Health is an equal opportunity employer and will recruit, hire, promote, and transfer qualified persons into all job classifications regardless of race, gender, religion, skin color, national origin or ancestry, physical disability (including pregnancy), mental disability, age, gender identity, sexual orientation, legally protected medical condition, family care status, marital status, veteran status, genetic characteristics, or any other characteristic protected by federal or state law. Vivent Health complies with other expanded protected classifications that specific county or municipal regulations may mandate. Vivent Health is deeply committed to fostering respect, dignity, and understanding for all individuals affected by HIV, regardless of race, ethnicity, sexual orientation, gender identity, socioeconomic status, or any other characteristic. We are dedicated to cultivating a supportive and inclusive environment that champions advocacy, education, and compassionate care for everyone in our diverse community. Going beyond the law’s requirements, Vivent Health places great importance on fostering a culture that celebrates diversity, equity, inclusion, and belonging. We actively seek qualified candidates from different racial, cultural, and economic backgrounds, as we believe that differing perspectives and experiences make us stronger as an organization. Vivent Health encourages all interested persons to apply for this position, and we look forward to learning more about your unique background and qualifications. As a recipient of federal funding, Vivent Health will not hire nor enter a contractual relationship with any party debarred, suspended, or excluded from federal assistance programs. Salary Range: $24.00/hourly - $25.00/hourly (Depending on Experience) The final salary will be determined based on factors such as market data, internal equity, candidate experience and qualifications. Please note that it is uncommon for an individual to be hired at or near the top of the range. Public Student Loan Forgiveness Employment at our organization may qualify you for federal student loan forgiveness programs. We do not directly pay for – nor forgive – federal student loans; however, our status as a not-for-profit organization under Section 501 (c) (3), makes us an eligible employer. There may be other determining factors for one to qualify. Please follow this URL to review one such program and their requirements: https://studentaid.gov/manage-loans/forgiveness-cancellation/public-service