Practice Manager, Pediatrics

We are a thriving Pediatrics Practice located in the Metrowest of Boston, seeking an enthusiastic and motivated Practice Manager to join our team. The successful candidate provides administrative oversight and business management to the practice, ensuring optimal patient experience. The PM oversees Finance, Billing, Operations, and Human Resources. The manager oversees the day-to-day operations of the practice, including preparing and analyzing monthly reporting, payroll oversight, financial management and coordination with accounting, hiring and training new staff, and more. He/she will work under a team of five physician partners who support the strategic direction of the practice.

This position is Monday through Friday on-site, with the option to work one day remotely.

Essential Functions

• Have an understanding of how all staff positions function and actively participate in the daily operation of the practice.

• Responsible for finances including bookkeeping, accounts payable and petty cash.

• Run monthly financial reports for accountant and partners.

• Process quarterly bonus payroll for partners and physicians.

• Administer 401k deposits and annual safe harbor contributions.

• Manage personnel related activities including attendance and performance management.

• Ensure all human resource forms, government forms, and insurance forms completed timely.

• Recruit, interview, and onboard new staff.

• Manage patient relations and resolve any related issues.

• Schedule and facilitate partners and team meetings; regularly meet with clinical and administrative managers for discuss staffing, HR policies, and other ideas.

• Attend hospital off site managers and quality improvement meetings.

• Manage office maintenance, insurance, and IT equipment in coordination with vendors.

• Work with billing, accounting, and credentialing teams to ensure continuity in eligibility and revenue cycle.

• Meet with medical records staff as needed and ensure HIPAA compliance.

Qualifications

• College Degree, preferably in a business discipline. Master’s Degree a plus

• Minimum five years’ experience, with at least two years of supervisory experience

• Prior experience in a healthcare setting, with a preference for private practice

• Comfortable with Microsoft suite of products

• Prior use of electronic medical record system(s)

• Excellent written and oral communication skills

• Experience with customer service; ability to communicate with patients and vendors in a pleasant and effective manner

• Proactive, organized, and detail-oriented

Posted 5-5-23

Supervisor PFS- Payment Posting and Reconciliation 

About us

Lifespan is a small business in Providence, RI. We are professional, agile, innovative and our goal is to Deliver Health with Care .

Our work environment includes:

• Modern office setting
• Food provided
• Wellness programs
• Growth opportunities

Under general direction of the PFS Manager, the Supervisor of Patient Financial Services assists in the day-to-day activities of Patient Financial Services payment posting, credit balances and reconciliation teams. Organizes, directs, and controls activities for Lifespan and affiliates for physician and hospital payment posting and reconciliation, credit balances for physician insurance and self-pay. Assists in identifying opportunities and implementing change within department guidelines, system enhancements and payer 835/Electronic Fund Transfers, resulting in the improvement of the cash flow, accuracy with cash posting and credit resolution.

• Assists Manager in the effective utilization of resources (people, financial, material and equipment) and overall budget monitoring to meet established operation and financial goals and objectives.
• In conjunction with the Manager, establishes priorities to ensure activities support established goals.
• In conjunction with the Manager, establishes priorities to ensure activities support established goals.
• Supervises and evaluates staff, provides guidance and counsel.
• Orients new staff, assigns work and establishes priorities. Regularly measures productivity and accuracy and provides individual feedback. Assists Manager with annual performance review.
• Develops and communicates standards and expectations for staff performance.
• Provides supervision in day-to-day- operations, implements approved procedures, monitors the quality of work performed by staff, ensures services are provided in accordance with established procedures and carried out in a prompt and courteous manner to meet/exceed customer service standards.
• Ensures staff is apprised of changes in policies and procedures that relate to area of responsibility, ensuring adherence to same.
• As appropriate, recommends corrective action to Manager and Director, up to and including termination.

BASIC KNOWLEDGE:

Associate’s Degree with knowledge of medical business office practices, human resource management/training, proficient in medical systems and additional training or experience in healthcare billing/coding/payment posting/follow-up and denials. Demonstrated knowledge of third party healthcare reimbursement regulations. Ability to think critically, have strong analytical skills with proficiency in Microsoft Excel. Report writing experience is helpful as is billing or coding certificate.

Experience:

Three to five years supervisory experience in full revenue cycle. Experience should demonstrate thorough knowledge of payment posting, credits and reconciliation in similarly complex healthcare organizations, as well as revenue cycle knowledge with effective communication, organizational, human resource and leadership skills. Must be familiar with ICD 10, CPT-4 coding, HCPCS, HCFA 1500 claims administration.

INDEPENDENT ACTION:

Functions independently within departmental policies and practices. Must be able to work independently in a manner to achieve goals, objectives and productivity requirements. Refers unresolved complex issues to Manager or Director where clarification of department policies and procedures may be required.

SUPERVISOR REESPONSIBILITIES:

Supervision for up to 30 FTE’s.

To apply: Please contact Ed Clark, Talent Acquisition at Lifespan. Eclark4@lifespan.org

Posted 3-2-23

Nurse Manager

We are a thriving, long-standing community pediatrics practice located in the MetroWest region of Greater Boston. In addition to our existing excellent clinical and administrative teams, we are seeking a Nurse Manager to complement our staff to continue providing high quality patient care in a positive, family-friendly environment for providers, patients, and employees alike.

The successful Nurse Manager will be an essential member of the clinical and management teams. This is a full-time leadership position, with the successful candidate splitting his/her time between administrative functions and direct patient care.

The position is on-site Monday through Friday daytime hours, with occasional weekend hours and evening phone availability on an as-needed basis.

Essential Functions

• Create nursing schedules, managing staffing levels and coverage

• Develop and implement training and education protocols for clinical non-clinical staff

• Develop and document clinical guidelines and procedures

• Work with Practice Manager and Front Desk Manager on a regular basis to coordinate seamless patient care

• Lead and attend regular nursing staff meetings

• Conduct performance reviews of nursing staff

• Team with the Practice Manager on HR matters and employee management

• Actively participate in nursing hiring

• Coordinate OSHA and BBP training for staff

• Coordinate CPR training for staff

• Coordinate PPOC mandated training for staff

• Ensure up to date licensure and continuing education for nursing and nursing support staff

• Oversee staff vaccinations and maintain records thereof

• Create and maintain protocols related to staff accidental exposures to infectious diseases

• Scheduled and manage Flu and COVID vaccine clinics

• Oversee vaccine ordering and supply management

• Oversee lab, make sure up to date protocols are in place

• Ensure the ordering of nursing and lab supplies

• Ensure proper function and timely inspection of medical equipment

Qualifications

• BSN degree, Master’s degree a plus (MSN, MHA, MPH, MBA)

• Current RN license

• Minimum seven years’ experience, with at least two years of supervisory experience

• Experience in the Pediatric specialty

• Comfortable with Microsoft Outlook, Excel, and Word

• Prior use of electronic medical record system(s), with a preference for Epic

• Excellent written and oral communication skills

• Experience with customer service; ability to communicate with patients and vendors in a pleasant and effective manner

• Organized and detail-oriented

Interested candidates should submit a resume for consideration. The position is full-time, with competitive pay and benefits commensurate with experience

Please contact Joanna Lambert at jlambert@edelsteincpa.com, or (617) 840-6048 to apply, or for additional information.

Posted 03-01-2023

Certified Billing and Coding Specialist, Ophthalmology

Job Description: We are a thriving, multi-site Ophthalmology practice located northwest of Boston, seeking a full-time or part-time Certified Ophthalmic Billing and Coding Specialist.

The Certified Biller/Coder will be responsible for medical billing, coding, obtaining authorizations, and patient account management which includes answering patient and clinic staff inquiries and resolving billing issues.

Detailed responsibilities are as follows;

Essential Functions

• Entering patient demographics and insurance coverage, verifying eligibility and benefits.

• Review and scrub charge entry of clinic and surgery charges, including monitoring and reviewing chart documentation, and assigning and appropriately linking CPT/ICD codes for claim accuracy, and monitoring posting reports for accuracy.

• Patient Account Management to include in clinic or phone inquiries and counsel patients on out-of-pocket estimates, self-pay balances, and payment plans.

• Daily and monthly reconciliation and balancing; performs internal audits of medical record documentation on a routine basis; communicates and educates doctors and staff as appropriate.

• Obtaining preauthorization for procedures and medications

• Chart auditing

• Stay up to date on coding changes

• Stay up to date of insurance requirements for billing and appeals

• Oversee billing service/company

• Prepare and run reports as needed

• Assist billing service/company with aging claims

• Patient and Insurance A/R follow-up

• Fielding billing-related questions

• Send patient invoices, notices

• Understanding and updating of insurance contracts

• Update fee schedules

• Maintain list of insurances accepted by provider

• Protects patient confidentiality, making sure protected health information is secured by not leaving PHI in plain sight

• PM software: Modernizing Medicine (EMA)

• Establishes standards for an excellent customer service environment in which all patients and staff are treated with dignity and respect

• Strong communication

• Participates in a teamwork culture

• Performs other duties as assigned

Qualifications

• High school diploma. College degree preferred

• The ideal candidate will possess CPT and ICD coding knowledge in medical practice and has a thorough understanding of medical terminology. Certification is strongly encouraged: Certified Professional Coder, CPC or Ophthalmic Coding Specialist, OCS.

• Minimum 3 years of medical billing experience in a physician office setting with knowledge of various medical payer practices and insurance laws/guidelines (Medicare, Medicaid, Work Comp, VA, and other third-party payers). 2 years of computer experience with more than two practice management A/R and Electronic Medical Record Systems.

• Experience in the Ophthalmology specialty

• Comfortable with Microsoft Outlook, Excel, and Word

• Prior use of electronic medical record system(s)

• Excellent written and oral communication skills

• Experience with customer service; ability to communicate with patients and vendors in a pleasant and effective manner

• Organized and detail-oriented

Interested candidates should submit a resume for consideration. The position is full-time, with competitive pay and benefits commensurate with experience.

Posted 12-19-22

Administrative Director, Ophthalmology

Job Description: We are a thriving, multi-site Ophthalmology practice located northwest of Boston, seeking a full-time Ophthalmic Administrative Director.  The Director provides administrative oversight and business management, ensuring optimal patient experience.  He or she works under the physician owner, supervising administrative staff.  The manager serves as the liaison to the medical billing company, performing in-office functions to facilitate timely and accurate patient billing and analysis of monthly reporting.  The manager performs administrative functions including supply orders, vendor management, mailing, and more.  He/she establishes and maintains office procedures, provides leadership, and maintains an environment of excellent customer service. 

Detailed responsibilities are as follows;

Essential Functions

·       Meets with physician leader to develop and implement business plans for the practice
·       Ensures the staff are performing duties and responding to customer and provider needs, including call volume management
·       Provides oversight of patient registration, insurance eligibility, co-pay collection, and ensures all requirements for third party billing are met
·       Manages practice schedules for staff and providers, monitors and reallocates staff workload
·       Supervises charge entry and coding
·       Develops and maintains a good working relationship with the billing vendor
·       Monitors inventory and expenses, signing off on invoices, and finds opportunities for increased cost-effectiveness
·       Runs management reporting to measure productivity, charges, payments, and collections
·       Participates in monthly financial meetings
·       Amends policies and procedures as needed
·       Maintains patient confidentiality and is compliant with industry regulations, keeping a pulse on healthcare trends
·       Identifies training gaps and develops training plans
·       Oversees payroll and time off requests
·       Establishes standards for an excellent customer service environment in which all patients and staff are treated with dignity and respect
·       Instills a culture of teamwork and optimizes staff performance
·       Performs other duties as assigned
 
Qualifications

·       College degree, preferably in a business discipline.  Master’s degree a plus
·       Minimum seven years’ experience, with at least two years of supervisory experience
·       Experience in the Ophthalmology specialty
·       Strong preference for Certified Ophthalmic Executive (COE), or in-progress
·       Work requires the knowledge and skills necessary to solve complex problems in the areas of clinical operations, business planning, financial management, marketing, personnel, and information systems management
·       Comfortable with Microsoft Outlook, Excel, and Word
·       Prior use of electronic medical record system(s)
·       Excellent written and oral communication skills
·       Experience with customer service; ability to communicate with patients and vendors in a pleasant and effective manner
·       Organized and detail-oriented
 
Interested candidates should submit a resume for consideration.  The position is full-time, with competitive pay and benefits commensurate with experience

Posted 12-19-22