Job Description

Location: Steward Medical Group - North
Posted Date: 2/20/2021

Steward Health Care is the largest private, tax-paying physician-led health care network in the United States. Headquartered in Dallas, Texas, Steward operates 35 hospitals in the United States and the country of Malta that regularly receive top awards for quality and safety. The company employs approximately 42,000 health care professionals. The Steward network includes multiple urgent care centers and skilled nursing facilities, substantial behavioral health services, over 7,900 beds under management, and approximately 2.2 million full risk covered lives through the company's managed care and health insurance services.

Steward Medical Group (SMG), Inc. is Steward's multi-specialty group practice with over 4,500 employees including over 1,800 physicians and advanced practitioners. SMG operates approximately 450 practice locations throughout Massachusetts, Southern New Hampshire, Rhode Island, Pennsylvania, Ohio, Florida, Utah, Arizona, Texas, Louisiana and Arkansas, and provides more than 4 million patient encounters per year.

Summary:

Responsible for the complete and accurate capture of patient insurance data and referral / authorization management. Includes tracking and creation of referrals for all visits. Contacts patients by telephone to collect missing pertinent data. Communicates with referring physicians and/or practices to obtain prior approvals for services. Reviews and responds to denied claims and works toward denial recovery.

Responsibilities:

  • "Provides superior customer service to internal and external clients, customers,
  • and patients as referenced in the Service Excellence Standards."
  • Practices and promotes a "patient-centered care model" within administrative standards.
  • Provides primary fiscal management of all patient insurance and insurance referral data. The principle focus is to ensure that all pending services have appropriate insurance coverage and is reimbursable. If a patient has no insurance coverage a free care application and approval must be on file prior to rendering services. It is the expectation that all pending services will be cleared for reimbursement 5 business days prior to the appointment date (unless it was added to the appointment schedule within that time frame).
  • It is expected that all telephone communication will be answered or initiated in a cheerful and welcoming manner as per the policy
  • Review and respond to all insurance rejection and/or claim denial reports and professional billing agencies. Initial review will be made in collaboration with the Manager. However, the Billing / Referral Coordinator is responsible for follow through of the recommendations made and achieving denial recovery of those charges. All responsive documentation is to be retained and filed for continual monitoring and follow up.
  • Coordination of all office supplies and documents.
  • Perform all other related or similar duties as required or as requested by the attending-in-charge or the Managing Director.
  • Coordination of all office supplies and documents.
  • Participates in role expansion, personal and center development.

Qualifications:

Minimum Education: H.S. diploma

Minimum Experience: 2-3 years insurance referral management

Experience with Microsoft Office, Word, Excel and Outlook required

Steward Health Care is an Equal Employment Opportunity (EEO) employer, Steward Health Care does not discriminate on the grounds of race, color, religion, sex, national origin, age, disability, veteran status, sexual orientation, gender identity, and or expression or any other non-job-related characteristic.

Additional Information

TextDescription automatically generated

Steward Medical Group is taking additional necessary preparations to ensure patients can receive compassionate care in safe, carefully managed environment – with confidence and without fear.

Our Safe and Ready program consists of a rigorous [three-point] standard ensuring patient safety, confidence and convenience.

  1. Any COVID-19 related care takes place in designated areas away from other patients and their families.
  2. A stringent cleaning policy has been implemented throughout our facilities.
  3. A strictly controlled visitor and mask policy is required for patient and colleague safety.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

Apply Online