Position: Authorizations Coordinator

Classification: Non-Exempt

Position Status: Full-Time

Reports to: Clinical Manager

Position Summary

The Authorizations Coordinator performs administrative, technical, and clinical support activities directed by the Clinical Manager. Authorizations Coordinator is a liaison among patients, third-party vendors, pharmacies, diagnostic imaging providers, insurance companies, and the clinic on a daily basis. As an Authorizations Coordinator, you would secure authorizations/approvals in a timely manner to ensure patients receive the care they need.

Essential Functions

• Submit and obtain authorizations for diagnostic imaging via third-party vendor or directly as needed.
• Submit and obtain authorizations for prescribed medications via designated online portal.
• Schedule in-house MRIs once authorizations are received.
• Review MRI screening checklists with patients.
• Manage all open imaging orders to ensure timely authorization and patient compliance.
• Manage all open prescribed medication authorizations.
• Educate patient on importance of timely follow-up with provider orders and medication changes if needed.

Competencies                                                                                                                          

• EHR
• Medical Terminology
• Customer Service
• Technical Capacity
• Analytical Skills                                                                                                   
• Communication Proficiency
• Organizational Skills

Supervisory Responsibility                                                                                                                                  

This position does not have supervisory responsibility.

Work Environment                                                                                                                                                             

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to sit, push, pull,  stand, walk, use hands to finger, handle or feel, and reach with hands and arms. On a regular basis, will be required to stand for long periods of time. On occasion, may be required to lift or move up to 10 pounds. Vision abilities required to perform the essential functions typically include close and distance vision, color and peripheral vision, depth perception and the ability to adjust focus.

Travel: May be required to travel between job sites based on patient load.  Travel is primarily local during the business day.

Required Education/Experience

• High school diploma or an equivalent combination of education, training, and experience                                   
• Valid NC Driver’s License
• 1 year of EMR experience
• Medical office experience

Preferred Education and Experience

• Associate degree in related field
• 1 – 2 years of authorization experience

Additional Eligibility Qualifications                                                                                                                           

None required for this position                       

Other Duties                                                                                                                                                                

Please note 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.

Position: Insurance & Authorization Specialist

Classification: Non-exempt

Reports to: RCM Manager

Hours:  Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m.

Position Summary
The Insurance & Authorization Specialist is responsible for verifying patient’s health care benefits by obtaining the eligibility status, benefit details, and authorization requirements. The Insurance & Authorization Specialist is equally responsible for obtaining and communicating any necessary authorizations or referrals for services performed or durable medical equipment dispensed.

Essential Functions

• Verifies patient insurance coverage timely utilizing phone or online resources to ensure necessary procedures are covered.
• Enters data timely in an accurate manner into the EMR system and verifies that existing information is accurate.
• Serves as a valuable resource to patients, providing them with pertinent information regarding their coverage.
• Submits all necessary authorization requests for services prior to being rendered.
• Ensures all pertinent medical documentation is accurate and present prior to submission.
• Assures authorizations or referrals have been approved with the proper CPT and ICD10 codes prior to services being rendered.
• Follows up with pending authorizations on a regular basis to obtain the current status or to be informed of any action needed in order to obtain the authorization approval.
• Communicates any authorization denials to the appropriate staff.
• Keeps patients abreast of the current status of their authorization if waiting time has exceeded the usual and customary expected time.
• Documents authorization details, status, and end result into EMR timely and prior to services being rendered.
• Handles any discrepancies, errors, or omissions of authorization denials.
• Schedules peer to peers with providers and communicates such meetings appropriately.
• Works collaboratively with the entire billing department to meet company goals.
• Participates in educational activities and attends regular staff and department meetings.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Stays abreast with current and upcoming payer billing requirements and regulations.

Competencies

• Strong understanding of medical terminology
• Working knowledge of payer billing requirements and regulations
• Strong organizational and multitasking skills
• Solid attention to detail to ensure accuracy of information
• Must be able to work independently and show leadership in decision making
• Effective communication and listening skills
• Excellent computer skills, including Word, Excel, and Google Drive

Supervisory Responsibility
This position has no supervisory responsibilities.

Work Environment
This job operates in a professional, clerical-administrative office environment. This role routinely uses standard office equipment such as computers, phones/headsets, photocopiers, filing cabinets, and fax machines.  

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk; use hands to finger, handle or feel; and reach with hands and arms. This position may require sitting for long periods of time during shift.

Travel
Travel is not required for this position.

Required Education and Experience 

• High school diploma
• A minimum of 2 years of successful experience within a medical billing setting working with insurance companies, and have extensive knowledge of different types of coverage and policies
• 1 – 2 years of EMR experience

Preferred Education and Experience 

• 3+ years experience in a medical billing setting and in a similar role                                               

Additional Eligibility Qualifications
None required for this position.

Other Duties      

Please note 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.

Position: RCM Manager

Classification: Exempt

Position Status:  Full-Time

Reports to: Director of Billing Operations/CEO

Hours:  Days and hours of work are Monday through Friday, 8:00 a.m. to 5:00 p.m.

Position Summary
The RCM Manager is responsible for the management and administration of daily operations for the billing department to include coordinating, planning, and facilitating activities necessary for the efficient operations of the billing department and billing staff.

Essential Functions

• Create and maintain a harmonious work environment through positive communication, feedback, mentoring, and coaching.          
• Oversees all operations within the billing department
• Ensures the workflow reaches maximum efficiency and productivity
• Point of contact for handling escalations and employee performance issues that impact the operations.
• Develop and deliver performance reviews, corrective actions, or counseling for staff
• Generate, interpret and analyze productivity reports to improve workflow, team performance, and customer satisfaction.
• Act as Subject Matter Expert (SME) for employee questions.
• Perform regular quality assurance audits on staff/functions within the billing department and meeting one on one with staff routinely to review results and provide feedback.
• Support of internal and external auditors
• Morning Huddles with staff to establish key goals for the day, week, month
• Proactive identification of simplification / automation opportunities
• Organization and active involvement in the training of new hires
• Demonstrate the ability to train effectively and cater to individual training needs
• Proactively manage and ensure compliance with control objectives
• Management of attendance and time-off requests to ensure adequate staffing at all times.
• Implement action plans to enhance customer experience and team performance.                                                                                                                         • Monitor individual and team performance and identify and act on both positive and negative performance trends.
• Keep corporation abreast of performance trends or concerns that impact operations.
• Be willing to perform all tasks within the team when necessary.
• Maintain an appropriate work environment and cleanliness of facility.
• Provide communication and training to ensure staff are fully informed of all new processes and procedures, customer needs, and company related issues.’Recognize individual and team achievements.
• Generate financial reports on weekly and monthly basis as necessary, and report to executive team on concerns, trends, and the overall financial health of the company
• Communication and training with provider team on billing and coding information
• Performing routine audits on medical records to ensure accuracy with billing and coding requirements
• ‘Meeting with provider team to review productivity reports and areas of opportunity
• Maintain compliance with OIG, CMS and other insurance payer policies.
• Creation and maintenance of company dashboards track and monitor financial data and productivity
• Maintain benchmarks for key performance indicators as established for optimal efficiency within the department’
• Creating, maintaining and updating department’s standard operating procedures as needed
• Working cohesively with other departments (front office and clinical) to ensure company wide efficiencies and compliance
• Credentialing of new providers and maintenance of existing providers’ credentialing status via CAQH and/or other payer specific methods
• Contracting with new insurance payers and/or negotiation of fee schedules
• Handling of EMR/IT support tickets for the billing department

Competencies

• Knowledge of the complete revenue cycle management model.
• Cross-trained in the essential functions of a Billing Specialist, including Charge Entry, Posting of Insurance and Patient Payments, Clearinghouse and EDI management, Accounts Receivables and Denial Management.
• Cross-trained in the essential functions of an Insurance Specialist, including verifications and authorizations.
• Strong understanding of medical coding.
• Strong organizational and people management skills.
• Solid attention to detail to ensure accuracy of information.
• Excellent computer skills, including Word, Excel, and Google Drive.
• Ability to present, communicate initiative, results, and analyses to multiple levels of management.

Supervisory Responsibility
This position has supervisory responsibilities.

Work Environment
This job operates in a professional, clinical office environment. This role routinely uses standard office equipment such as computers, phones/headsets, photocopiers, filing cabinets, and fax machines.  

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk; use hands to finger, handle or feel; and reach with hands and arms. This position may require sitting for long periods of time during shift.

Travel
This position may require employee to travel between clinic locations.

Required Education and Experience 

• Bachelor’s degree in relevant field or an equivalent combination of education, training and experience.
• 2 years of successful, progressive supervisory experience within a medical billing setting
• 2 years of EMR experience.
• CPC Certification

Additional Eligibility Qualifications

• None

Other Duties      

Please note 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.

Position: Physician Extender

Classification: Exempt

Reports to: Medical Director

Hours:  40 hrs/week

Position Summary
Our practice specializes in spine & pain management with locations in the desirable Triangle, NC area. We treat a range of chronic pain disorders by employing a sophisticated combination of procedures/modalities to achieve optimal long-term results.  As a Physician Extender, you will join a team of highly-skilled professionals that collectively treat patients through medication management, minor procedures including ultrasound guided joint injections and implantable pain relieving devices. You will work in a collaborative environment with other medical professionals to review and discuss medical problems, diagnostic tests, and therapeutic procedures.

Essential Functions

• Orders diagnostic and therapeutic procedures/studies as appropriate
• Performs clinical procedures (i.e., trigger points, joint injections)
• Reviews and interprets diagnostic studies with patient and forms treatment plan
• Provides pre and post procedure education and counseling for all patients undergoing minor procedures including ultrasound guided joint injections and implantable pain relieving devices
• Initiates and monitors medication and treatment in accordance with the current standards of care
• Evaluates need for immediate care and/or referral to other disciplines
• Completes notes in a timely manner
• Completes patient forms as necessary, including FMLA, disability, etc
• Takes after hours call (on phone) in rotation with other providers

Competencies

• Professionalism
• Empathy and compassion
• Interpersonal and communication skills (orally and in writing)
• Dependability
• Strong commitment to teamwork
• Technical Capacity

Work Environment
This job operates in a professional, clinical office environment. This role routinely uses standard office equipment such as computers.

Required Education and Experience 

• Masters Degree in Physician Assistant Studies or Masters Degree in Nursing

Additional Eligibility Qualifications

• Valid Medical License to Practice in the state of North Carolina required.
• Valid DEA required.

Position: Physician Extender

Classification: Exempt

Reports to: Medical Director

Hours:  40 hrs/week

Position Summary
Our practice specializes in spine & pain management with locations in the desirable Triangle, NC area. We treat a range of chronic pain disorders by employing a sophisticated combination of procedures/modalities to achieve optimal long-term results.  As a Physician Extender, you will join a team of highly-skilled professionals that collectively treat patients through medication management, minor procedures including ultrasound guided joint injections and implantable pain relieving devices. You will work in a collaborative environment with other medical professionals to review and discuss medical problems, diagnostic tests, and therapeutic procedures.

Essential Functions

• Orders diagnostic and therapeutic procedures/studies as appropriate
• Performs clinical procedures (i.e., trigger points, joint injections)
• Reviews and interprets diagnostic studies with patient and forms treatment plan
• Provides pre and post procedure education and counseling for all patients undergoing minor procedures including ultrasound guided joint injections and implantable pain relieving devices
• Initiates and monitors medication and treatment in accordance with the current standards of care
• Evaluates need for immediate care and/or referral to other disciplines
• Completes notes in a timely manner
• Completes patient forms as necessary, including FMLA, disability, etc
• Takes after hours call (on phone) in rotation with other providers

Competencies

• Professionalism
• Empathy and compassion
• Interpersonal and communication skills (orally and in writing)
• Dependability
• Strong commitment to teamwork
• Technical Capacity

Work Environment
This job operates in a professional, clinical office environment. This role routinely uses standard office equipment such as computers.

Required Education and Experience 

• Masters Degree in Physician Assistant Studies or Masters Degree in Nursing

Additional Eligibility Qualifications

• Valid Medical License to Practice in the state of North Carolina required.
• Valid DEA required.

Position: Physician

Classification: Exempt

Reports to: Medical Director

Hours:  40 hrs/week

Position Summary:
Growing Pain Management  practice in North Carolina is seeking an ACGME accredited fellowship trained Interventional Pain Physician for a full time position. This is an excellent opportunity to join a very reputable and established group of highly trained interventional pain physicians and mid-level practitioners.

Work Schedule:

Excellent work life balance with no weekends.

Salary and Benefits:

First year compensation $375K+. Four weeks paid time off and one additional week paid CME. This position also offers an exceptional benefits package which includes malpractice insurance, medical, dental, vision, life, 401(k).

Essential Functions:

• The qualified candidate will be expected to perform evaluation and management of chronic pain patients with robust volume of pain procedures.
• Position will require extensive experience doing Lumbar and Cervical Epidurals, Facet Injections, and Radiofrequency Ablations, Other procedures include Nerve Blocks, Joint/Bursa, Spinal Cord Stimulation trials, Kyphoplasty, and PRP.
• The qualified candidate will perform New Patient, Follow-up, Procedure, and Telehealth visits.
• Supervision of Physician Assistants or Nurse Practitioners required.
• Will be required to market practice to referring physicians and attend marketing events as needed.

Supervisory Responsibility:
This position will have Supervisory responsibilities of Physician Extenders.

Work Environment:
This job operates in a professional, clinical office environment. This role routinely uses standard office equipment such as computers and medical equipment such as C-Arm, Radiofrequency ablation machine and Ultrasound machine.
    

Required Education and Experience: 

• Must be Board Certified or Board Eligible in Interventional Pain Medicine
• Must be Board Certified in Physical Medical & Rehabilitation or Anesthesiology

Additional Eligibility Qualifications:

• Valid Medical License to Practice in the state of North Carolina required
• Valid DEA required

Email resume to manager@wakespine.com or call (919) 867-1907

Position: Physician

Classification: Exempt

Reports to: Medical Director

Hours:  40 hrs/week

Position Summary:
Growing Pain Management  practice in North Carolina is seeking an ACGME accredited fellowship trained Interventional Pain Physician for a full time position. This is an excellent opportunity to join a very reputable and established group of highly trained interventional pain physicians and mid-level practitioners.

Work Schedule:

Excellent work life balance with no weekends.

Salary and Benefits:

First year compensation $375K+. Four weeks paid time off and one additional week paid CME. This position also offers an exceptional benefits package which includes malpractice insurance, medical, dental, vision, life, 401(k).

Essential Functions:

• The qualified candidate will be expected to perform evaluation and management of chronic pain patients with robust volume of pain procedures.
• Position will require extensive experience doing Lumbar and Cervical Epidurals, Facet Injections, and Radiofrequency Ablations, Other procedures include Nerve Blocks, Joint/Bursa, Spinal Cord Stimulation trials, Kyphoplasty, and PRP.
• The qualified candidate will perform New Patient, Follow-up, Procedure, and Telehealth visits.
• Supervision of Physician Assistants or Nurse Practitioners required.
• Will be required to market practice to referring physicians and attend marketing events as needed.

Supervisory Responsibility:
This position will have Supervisory responsibilities of Physician Extenders.

Work Environment:
This job operates in a professional, clinical office environment. This role routinely uses standard office equipment such as computers and medical equipment such as C-Arm, Radiofrequency ablation machine and Ultrasound machine.
    

Required Education and Experience: 

• Must be Board Certified or Board Eligible in Interventional Pain Medicine
• Must be Board Certified in Physical Medical & Rehabilitation or Anesthesiology

Additional Eligibility Qualifications:

• Valid Medical License to Practice in the state of North Carolina required
• Valid DEA required

Email resume to manager@wakespine.com or call (919) 867-1907

Position Summary

The Front Desk Receptionist is responsible for providing excellent customer service for all front desk, patient-oriented services by using effective, in-depth knowledge of company policies and practices.

Essential Functions

• Manage multi-line phones with ability to manage multiple priorities with little or no direction.
• Answer inbound calls in a prompt, polite and professional manner.
• Make outbound calls to confirm appointments and reschedule, when applicable.
• Manage voice mail and phone forwarding after hours.
• Obtain and enter accurate demographic information into EMR or provided database (address, telephone number, insurance, etc.).
• Schedule appointments for patients (review appointment date, time, provider, and location for accuracy).  
• Answer questions about service details, the company, and issues regarding the patient’s account.
• Act as a liaison for the patients for all WSPS locations.  
• Interpret patient accounts and explain billing information.  
• Manage fax server and process all incoming and outgoing faxes accurately.
• Scan of all medical records and documentation into EMR.
• Check in to include collecting and posting payments, patient intake, and updating patient demographics.
• Check out to include scheduling procedures and follow-ups, generating receipts, patient statements, and ledgers.
• Monitor patient wait times and customer satisfaction.
• Handle all medical record requests to include social security, disability, and attorney requests.
• Verify insurance benefits as needed utilizing online tools and phone.
• Obtain authorizations for procedures from all insurance plans and/or worker’s compensation plans as needed.
• Maintain waiting room cleanliness and appearance.
• Maintain a clean and organized work area at all times.

Competencies

• Exceptional customer service skills
• Strong organizational and multitasking skills
• Highly organized with a solid attention to detail to ensure accuracy of information
• Technical capacity with excellent computer skills, including Word, Excel, and Google Drive
• Self motivated with the ability to work autonomously or as a team member
• Display flexibility in scheduling and duty assignments
• Strong time management skills
• Interpersonal skills
• Problem solving skills

Supervisory Responsibility
This position has no supervisory responsibilities.

Work Environment
This job operates in a professional, clerical-administrative office environment. This role routinely uses standard office equipment such as computers, phones/headsets, photocopiers, filing cabinets and fax machines.   

Physical Demands
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  

While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit, stand, walk; use hands to finger, handle or feel; and reach with hands and arms. This position may require sitting for long periods of time during shift.

Travel
Travel may be required based on patient load.

Required Education and Experience  

• High school diploma
• 1 – 2 years successful experience in a front desk receptionist position in a medical office or equivalent setting

Preferred Education and Experience  

• 1 – 2 years of EMR experience
• Associate’s degree and/or Certification in Medical Office Administration
• Ability to exercise judgment and make sound decisions under pressure
• Able to diplomatically and professionally interact with customers and team members
• Ability to communicate effectively, both orally and in writing
• Excel in diagnosing and troubleshooting complex situations
• Effective listening skills

Additional Eligibility Qualifications
None required for this position.  

Other Duties       

Please note 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.  

Medical Assistant

Wake Spine and Pain Specialists is seeking a full-time Medical Assistant with experience in orthopedics or pain management preferred. Must be outgoing, friendly, highly professional, detail-oriented and able to multi-task.

EMR experience a must – please list which EMRs you have used and are familiar with.

Primary Job Responsibilities include but not limited to:

• Patient Intake – taking height, weight, vitals, medical history
• Procedure Room Assisting – managing fluoroscopy machine, documenting procedure notes, prepping room for physician
• Diagnostic Imaging – authorizing, scheduling, obtaining results via websites
• Telephone Triage
• Out-going referrals
• Medical Supply Ordering and Inventory Control
• EMR data entry
• Patient Education
• Urine Drug Screening
• Oral swab screening
• Pulling NC Controlled Substance Databases
• Documentation of Lab Results
• Fitting DME such as back braces and TENS units
• Patient Education of DME
• Diagnostic Imaging – authorizing, scheduling, obtaining results via websites
• Scheduling

Occasional responsibilities include:

• Front Desk check-in, check-out, collecting & posting payments, handling new patient referrals