Top Quality Management Executive - Healthcare oversees all aspects of the quality management function for a hospital or other healthcare facility. Develops plans designed to improve the overall quality of the organization's facilities and patient care services. Being a Top Quality Management Executive - Healthcare oversees the implementation of quality improvement efforts designed to improve clinical performance and maintain compliance with JCAHO, HIPAA, and other accreditation standards. Responsible for planning and directing quality policies, programs, and initiatives. Additionally, Top Quality Management Executive - Healthcare requires a MD from an accredited school. Requires a valid state license to practice. Typically requires extensive clinical experience. Typically reports to a top management. The Top Quality Management Executive - Healthcare manages a business unit, division, or corporate function with major organizational impact. Establishes overall direction and strategic initiatives for the given major function or line of business. Has acquired the business acumen and leadership experience to become a top function or division head. (Copyright 2024 Salary.com)
Job Summary:
This is a clerical position that involves the filing and tracking of insurance claims and informing patients of their account status. Work is performed in accordance with NOMS policies and procedures/applicable federal and state laws. Effective performance requires independent action under general supervision.
Essential Functions:
1. Process insurance and disability claims in a timely manner.
2. Follows up with insurance companies ensuring that claims are paid correctly.
3. Follows up with patient on balances, sets up payment plans if needed.
4. Maintains strict confidentiality related to medical records and other data.
5. Participates in professional development efforts to ensure currency in health care practices and trends.
6. Answers patients’ inquiries regarding account balances.
7. Daily use of phone.
8. Provide monthly summary reports to physicians, CEO, CFO, and Director-CBO.
9. Other duties as assigned.
Competencies:
1. Knowledge of NOMS policies and procedures.
2. Knowledge of medical diagnostic coding system, medical terminology and insurance practices.
3. Verifiable ability to input data into computer system with reasonable speed and accuracy.
4. Ability to organize and process work efficiently.
5. Proven multi-tasking capability.
6. Knowledge of computer programs and applications
7. Ability to work under stress with frequent interruptions.
8. Ability to independently assume other responsibilities in addition to routine duties.
9. Must be a team player and self-motivator.
Education and Work Experience:
1. Prefer past medical office billing experience. Typing ability and Word processing/computer skills.
2. Minimum of one-year medical billing preferred.
3. High school graduation or GED.
4. RHIT preferred but not required.
Environmental/Working Conditions:
Office setting, well-ventilated and well lighted. Work involves frequent telephone contact with patients. Work may be stressful at times. Interaction with others is constant and interruptive.
Physical/Mental Demands:
Normal office environment. Work is typically performed at a desk or table requiring the use of standard office equipment. Intermittent sitting, standing and stooping. May view computer screen for long periods of time. Work may be stressful at times. Interaction with others is constant and interruptive.
OTHER DUTIES: This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
NOMS is an equal opportunity employer committed to high standards of business conducted and civic responsibility. This includes our policy of offering fair and equal opportunities to every employee or applicant for employment regardless of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation) age, national origin, disability or genetic information, or status as a Vietnam-Era or special disabled veteran, or any other protected classes, in accordance with applicable law.
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