Responsible for collecting, posting and managing account payments; responsible for submitting clean claims and following up with insurance companies.

Duties and Responsibilities:

• Prepares and submits clean claims to various insurance companies electronically (or by paper).
• Accurate data entry of patient demographic information, charge entry, posting receipts, adjustments and reserves in accordance with EOBs and patient checks.
• Reviews and processes payments verifying insurance companies are paying according to their fee schedules.
• Investigates and follows up on all outstanding accounts and works denials within 3 days of receiving.
• Processes appeals as needed.
• Recoupments from payers to be handled within 3 days.
• Notify management immediately upon the receipt of a RAC or payer audit.
• Has working knowledge of various insurance plans and collects co-pays and deductibles as indicated by third party payers.
• Evaluates records and prepares reports, on such topics as number of denied claims or documentation or coding issues, for review by management.
• Post all manual and electronic payments within 24 hours of receipt.
• Audit of EOB posting should have a 95% or higher correct posting rate.
• Maintain insurance payer buckets within MGMA standards for the agency.
• Communicates denials for coding and documentation to coders and management for review.
• Interact appropriately with difficult patients in an attempt to resolve any questions regarding charges or payments.
• Understanding of computer system in order to assist patients with billing problems.
• Assist in other job duties related to front office.
• Participates in educational activities and attends routine staff meetings.
• Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
• Performs other duties as assigned by management.

Knowledge, Skills, and Abilities

• Knowledge of medical billing, coding, and business office procedures.
• Knowledge of computer programs and basic office equipment.
• Knowledge of Medicare reimbursement guidelines; and third-party operating procedures and practices including comprehension of explanation of benefits (EOBs).
• Ability to research and analyze data, resolve issues. Must be multi-tasking, well organized, and detail-oriented.
• Ability to multitask, prioritize and meet deadlines.
• Excellent written and verbal communication skills.
• Maintain CEUs as necessary to maintain certification.

Software Access

• Microsoft Office
• eClinialWorks
• Acrobat Pro

Minimum Qualifications

A High School Diploma and two to four years’ experience in billing, reimbursement, and denial management. Completion of accredited certification insurance billing program AAPC /AHIMA is required or must be obtained within 1 year of employment. (CPB – Certified Professional Biller)

This position compiles and maintains accounting documentation and other tasks as assigned.

Duties and Responsibilities:

• Enter invoices into the accounting software.
• Enter Thrive Assistance Program Assistance payments into accounting software.
• Complete documentation necessary to process payments.
• Custodian of petty cash.
• Distribute payments to vendors.
• Assist with 1099 documentation.
• Assist with contract administration by scanning, filing, advisement of contract expiration, revision of contracts as directed, and obtaining signatures.
• Place online orders by credit card and on account for departments and file documentation as appropriate.
• Assist with ordering janitorial supplies and invoice review as needed.
• Review gas card transactions, add/remove users and vehicles, and generate reports as needed.
• Assist with general credit card reconciliation.
• Assist with purchasing process as it is redefined.
• Assist with maintaining hardcopy and scanned files.
• Assist with security system administration as directed.
• Generate reports as needed in procurement software.
• Communicate with vendors regarding delivery, invoices and related matters.
• Perform online research for materials, supplies and equipment to provide data for decision making.
• Compare invoices to contracts and agreements for accuracy.
• Other duties as assigned.

Knowledge, Skills, and Abilities

• Ability to use computer software including spreadsheets, databases and word processing application
• Ability to multitask and prioritize
• Ability to maintain confidentiality of privileged information obtained in the course of work
• Attention to detail
• Ability to organize and communicate effectively.

Software Access

• Microsoft Office
• Cabinet
• Adobe PDF

Minimum Qualifications

A high school diploma or equivalent and three years general office experience

The incumbent in this position serves as a vital member of the healthcare team by utilizing phlebotomy skills to obtain samples from patients for analysis.

Duties and Responsibilities

• Obtain blood specimens by established venipuncture and capillary techniques (adult and pediatric), as well as urine or other samples as ordered by the clinician.
• Process, package, and route specimens to the appropriate laboratory while maintaining specimen integrity by approved laboratory methods.
• Run routine CLIA-waived in-office tests (e.g., urine pregnancy, strep A, influenza, urine dipstick).  Ensure Quality Control is performed and documented.  Troubleshoot if QC is out of acceptable range.
• Ensure safe handling of blood products and proper disposal of hazardous waste.
• Assist in compliance with OSHA standards and AAC policies and procedures for infection control by maintaining a clean and sterile environment, including daily cleaning of the lab and emptying of biohazard bags. 
• Maintain log book(s) for specimens sent each day.
• Receive and enter lab results into the patient's electronic medical record (EMR) and CAREWare.
• Maintain Temperature logs twice a day on the laboratory refrigerator, freezer and room temp.  Troubleshoot if temperatures are out of range.
• Inventory control of laboratory supplies.
• Review pending labs and investigate if any are missing.
• Report equipment or lab deviations to lab supervisor, take action to remediate.
• Collaborate with providers and Director of Nursing to discuss updates on clinical lab tests and specimen collection.
• Conducts investigation into receiving lab or collection discrepancies.  Presents resolutions to supervisor.
• Assist at ancillary sites as needed.
• Participate in Quality Improvement Project.
• Provide coverage at other Thrive Alabama facilities as needed.
• Maintain Phlebotomy certification
• All other duties as assigned. 

Knowledge, Skills, and Abilities

• Knowledge of basic concepts of HIV transmission, prevention and disease process.
• Knowledge of specific laboratory solutions, materials, and media necessary to perform duties.
• Knowledge of HIPAA confidentiality requirements and commitment to safeguarding client information.
• Basic computer literacy for data entry, including Microsoft Excel and EMRs.
• Ability to prioritize needs and plan work assignments accordingly.
• Ability to work with patients, significant others and family members from diverse populations.
• Ability to communicate effectively and maintain working relationships with others.
• Ability to lift and carry a minimum of 30 pounds, sit for extended periods of time, and walk between office buildings.

Software Access

• Microsoft Office
• eClinical Works
• CAREWare

Minimum Qualifications

• High school diploma and at least one (1) year of laboratory experience.
• Certification in Phlebotomy from an accredited college or technical school may substitute for the required experience.

Maintain provider credentialing. Responsible for collecting, posting and managing account payments; responsible for submitting clean claims and following up with insurance companies.

Duties and Responsibilities:

• Processes practitioner applications and accompanying documents, ensuring applicant eligibility for credentialing.
• Conducts verification of previous insurance credentialing through research and primary source verification of all components of the insurance credentialing application.
• Identifies issues requiring additional investigation and evaluation, validates discrepancies and ensures appropriate follow-up of the insurance credentialing application.
• Ensures file completion within appropriate time restrictions.
• Completes requests for Hospital privileges within specific time period.
• Responds to inquiries from other healthcare organizations, interfaces with internal and external customers and Providers on day to day credentialing and privileging issues as they arise.
• Monitors the reappointment and expiration process for all medical staff, Allied Health Professional staff, Other Health Professional staff, and delegated providers, ensuring compliance with regulatory bodies (Joint Commission, NCQA). Credentials the providers with Medicare, variety of Health Plans, Hospitals, Clinics, and updates CAQH for providers (as applicable).
• Updates and maintains credentialing grids, by provider, by location, by commercial carrier.
• Liaison to outside consultant(s) regarding group and/or individual contract enrollments, renewals and terminations (as applicable).
• Assist in the preparation and submission of clean claims to various insurance companies electronically (or by paper).
• Accurate data entry of patient demographic information, charge entry, posting receipts, adjustments and reserves in accordance with EOBs and patient checks.
• Working knowledge of various insurance plans and collects co-pays and deductibles as indicated by third party payers.
• Assist in the posting of all manual and electronic payments within 24 hours of receipt.
• Audit of EOB posting should have a 95% or higher correct posting rate.
• Maintain self- payer buckets through collections within MGMA standards for the agency.
• Responsible for monthly patient statements and collection calls.
• Ability to interact appropriately with difficult patients in an attempt to resolve any questions regarding charges or payments.
• Understanding of computer software in order to assist patients with billing issues.
• Ability to assist in other job duties related to front office.
• Participates in educational activities and attends routine staff meetings.
• Maintains strict confidentiality; adheres to all HIPAA guidelines/regulations.
• Performs other duties as assigned by management.

Knowledge, Skills, and Abilities

• Knowledge of medical billing, coding, and business office procedures.
• Knowledge of computer programs and basic office equipment.
• Knowledge of Medicare reimbursement guidelines; and third-party operating procedures and practices including comprehension of explanation of benefits (EOBs).
• Ability to research and analyze data, resolve issues. Must be multi-tasking, well organized, and detail-oriented.
• Ability to multitask, prioritize and meet deadlines.
• Excellent written and verbal communication skills.
• Maintain CEUs as necessary to maintain certification.

Software Access

• Microsoft Office
• eClinialWorks
• Acrobat Pro

Minimum Qualifications

A High School Diploma and two to four years’ experience in billing, reimbursement, and denial management. Completion of accredited certification insurance billing program AAPC /AHIMA is required or must be obtained within 1 year of employment. (CPB – Certified Professional Biller)

This position is responsible for managing patient appointments, patient information and payment processing through accurate and timely data entry. This position will have dual supervision when working in satellite clinic: time and attendance will fall under the Clinic Manager and all duties below will fall under the Patient Access Manager.

Duties and Responsibilities

• Conduct insurance eligibility and intake process to include financial assistance interviews. After collecting all required documentation, explain insurance benefits, copay obligations, service fee requirements per sliding fee scale to patients: collect copays/fees post to patient EMR account.
• Schedule/cancel/reschedule all appointments according to patient request and/ or scheduling guidelines including those requested through Healow or EMR portal.
• Ensure that all required patient demographic information is entered and updated as required in both EMR and CAREWare. Enter all medical encounters into CAREWare. Obtain photo ID, insurance cards and take patient photo using the kiosk for medical record.
• Ensure that Release of Information (ROI), HIPPA and Patient Consent are obtained on all patients, updated as needed and scanned in the patient’s Electronic Medical Record (EMR). Scan all medical records and lab documents into EMR for clinic.
• Answer multiline telephones, route calls and mail/correspondence to appropriate depts. Document patient communication and assign telephone encounters from answering service messages from the day prior.
• Ensure services provided are In accordance with HRSA designation standards.
• Assist in collecting structured data for UDS reporting
• Arrange for special patient needs prior to the appointment date/time; interpreter, wheelchairs, transportation, etc.
• Ensure patients are greeted in a professional manner.
• Enroll all patients in patient portal, Healow app and instruct patient on Kiosk use.
• Ensure patient has received all services scheduled for before checking out.
• Ensure that Ryan White funds are the payer of last resort while fulfilling the needs of the clients.
• Review patient appointments for following clinic day, make reminder calls.
• Respond to questions/issues related to patient insurance and bills.
• Obtain patient satisfaction survey on all patients
• Explain patient policy and procedures to patient for no shows, payment plans, etc.
• Reconcile cash drawer to ensure accuracy and prepare the drop at end of each day.
• Travel is required to attend meetings, seminars and to cover satellite clinics as needed.
• Fax all medical records requests and follow-up to ensure receipt of requested records.
• Participate in quality improvement projects as directed by manager.
• Attend team meetings.
• All other duties assigned by supervisor

Knowledge, Skills, and Abilities

• Knowledge of HIPAA laws.
• Knowledge of Ryan White or other grant requirements.
• Knowledge of basic bookkeeping
• Knowledge of the procedures and practices for receiving, disbursing and depositing cash.
• Ability to deal with the public in a tactful and courteous manner.
• Knowledge of the basics of HIV transmission, disease process and prevention.
• Ability to communicate effectively.
• Ability to establish and maintain effective working relationships with others.

Software Access

• Microsoft Office
• eClinical Works
• CAREWare
• Healow Agent
• Adobe Reader
• Join Me

Minimum Qualifications

• A high school diploma and one year of clerical experience in a medical environment.
• A GED may substitute for the required high school diploma.

Duties and Responsibilities

• Maintain the general ledger, preparing a variety of reconciliations and journals.
• General ledger analysis.
• Collect and analyze financial data to ensure that all reporting is in compliance with GAAP guidelines.
• Completes financial month end process for Controller’s review.
• Prepare monthly and year-end financial reports with budgetary comparison and variance explanations for review by Controller.
• Develop an indirect rate and monitor rate once in place.
• Collaborate with the Medical Billing Specialist to accurately account for program income.
• Develops and updates department budget reports for directors.
• Monitor program income to ensure appropriate spending.
• Reconcile all bank accounts.
• Assist Controller and HR Manager with payroll processing as needed.
• Assist Controller with processing monthly and quarterly payroll tax payments.
• Provide information to Controller, CFO and auditor for annual audit.
• Other related duties as assigned.

Knowledge, Skills, and Abilities

• Knowledge of accounting principles, practices and procedures.
• Knowledge of the methods of data collection.
• Ability to research and resolve account reconciling items.
• Ability to understand and apply applicable rules, regulations, policies and procedures relating to an accounting program.
• Ability to prepare financial statements, reports, and other accounting records.
• Ability to analyze and interpret accounting data.
• Ability to plan, organize and coordinate work assignments.
• Ability to communicate effectively and maintain working relationships with others.

Software Access

• Microsoft Office
• Financial Edge- Accounting Level III
• Cabinet
• Acrobat Pro

Minimum Qualifications

Candidate must have a bachelor's degree from an accredited college or university with a major in accounting and five (5) years of experience with an automated accounting or financial system. Experience with Blackbaud or similar non-profit accounting software, as well as experience within a medical environment, is preferred but not required. Current CPA license preferred but not required.