Lead Medical Office Specialist

Job Summary :

The Providence Center helps adults, adolescents and children affected by psychiatric illnesses, emotional problems and addictions by providing treatment and supportive services within a community setting.

The Lead Medical Office Specialist works closely with Specialist Team and Revenue Cycle to ensure all insurance issues are resolved in a timely manner. Serves as a resource to management and clinical staff if insurance questions arise. Meets with Clinical Management teams if necessary to discuss insurance issues. Train Medical Office Specialists and create "Tip Sheets" for staff. Attend Administrative / Billing meetings when needed. Works onsite Monday through Friday from 7 : 30am-3 : 30pm.

Duties and Responsibilities :

Coordinate day-to-day operations of the Specialist Teams, train staff when necessary, and ensure timely completion of tasks.

Problem-solve when necessary and continually improve processes.

Ensure updated information is obtained and communicated to all Specialists regarding insurances and services.

Contact insurance and managed care companies, and other reimbursement sources pertaining to authorization for services and benefits, as appropriate.

Troubleshoot insurance and authorization issues.

Oversee work queues daily to ensure compliance.

Work on provider templates, blocking, recurring.

Provide timely responses to questions regarding insurance coverages.

Provide coverage for specialists and / or medical office assistants during leave of absence or scheduled time off when needed.

Complete monthly Federal Meal Program by the 5th of each month

Complete monthly billing through DCYF Portal by 5th of each month

Ensure up to date knowledge about insurances and advise clinicians when authorization might be needed for additional sessions.

Perform special projects to support Director, Sr. Operations Manager and Asst. Office Manager.

Attend mandatory in-service trainings and other required trainings.

Provide training to other support staff as needed.

Other duties as assigned.

Requirements :

High School or GED required, additional education a plus.

Minimum 1 to 3 Years of third-party reimbursement in a busy setting or equivalent combination of education and experience.

General computer experience is also required.

Initiative, good judgment and dependability.

Ability to prioritize and handle multiple assignments.

Must possess good typing skills as well as good spelling and grammar.

Excellent communication skills are a must.

Excellent customer service skills.

Bilingual Spanish preferred.

Manual dexterity and mobility required. While performing the major responsibilities of this position, the incumbent must be able to regularly sit, stand or walk, and occasionally reach for prolonged periods of time. Must be able to lift, push, move and / or carry supplies or equipment up to 25 pounds, and occasionally be able to bend, stoop, crouch or kneel.

Care New England Health System (CNE) and its member institutions; Butler Hospital, Women & Infants Hospital, Kent Hospital, VNA of Care New England, Integra, The Providence Center, and Care New England Medical Group, and our Wellness Center, are trusted organizations fueling the latest advances in medical research, attracting top specialty-trained doctors, and honing renowned services and innovative programs to engage in the important discussions people need to have about their health.

Americans with Disability Act Statement : External and internal applicants, as well as position incumbents who become disabled must be able to perform the essential job-specific functions either unaided or with the assistance of a reasonable accommodation, to be determined by the organization on a case-by-case basis.

EEOC Statement : Care New England is an equal opportunity employer. All applicants will be considered for employment without attention to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran or disability status.

Ethics Statement : Employee conducts himself / herself consistent with the ethical standards of the organization including, but not limited to hospital policy, mission, vision, and values.