Graham Healthcare Group

Customer Support

• Responsible for providing assistance and support for the Bob Hogue School of Real Estate support team and student base.
• Monitor all incoming phone activity, providing enrollment assistance to students and general information for all real estate study programs.
• Mentor new hires and assist Management team by performing general staff evaluations for quality control.
• Provides administrative and clerical support for school business office and assists management team and Instructor staff with specific duties related to class delivery.
• Answer all incoming phone calls and provide product information to new students.
• Advise students on the licensing process, answer questions and enroll students in study programs based on their specific needs.
• Monitor company voice mail system for calls received after hours and return unanswered calls.
• Process material and classroom enrollment orders received via company website.
• Provide students with technical support which includes, but is not limited to: system log-in assistance, resetting passwords, navigating online courses, evaluating final exam reports and assisting with online purchases.
• Assess customer complaints and concerns and escalate to management team as needed.

Customer Support Specialist, I

QA Engineer

• Responsible for quality-driven review of documentation of care center staff members, including the Comprehensive Admission Assessment, starts of care, Certification of Terminal Illness, HIS and other related documents, ensuring appropriateness of care, delivery and documentation requirements are met.
• Ensures the assignment of the appropriate clinical pathways on the plan of care
• Ensures missing, incomplete, and/or untimely documentation issues are resolved.
• Ensures benefit periods are assigned accurately.
• Ensures communication of changes in the plan of care are documented completely and correctly.
• Participates in quality assurance activities designed to improve the quality and continuity of patient care.
• Performs chart audits and other activities of data collection.
• Responds to Additional Documentation Requests/Denials as directed.
• Performs chart audits as directed to monitor documentation and patient clinical records to ensure compliance with agencies policies and procedures and all regulatory inspection agencies.
• Keeps abreast of nursing trends and knowledge.
• Exceptional attention to detail
• Strong knowledge of regulatory guidelines and best practices
• Focused Quality attention
• Performs other related duties as assigned or requested.
• Demonstrates initiative and skills in planning and organizing work.
• Cooperates with scheduling requests to meet department needs.
• Demonstrates a desire to set and meet objectives and to find increasingly efficient ways to perform tasks.
• Completes work with accuracy and within department time frames.
• Is flexible to changes in duties and responsibilities.

Quality Assurance Registered Nurse

Billing Specialist

• Support Billing Management to ensure timely and correct claims are filed with all respective payers and intermediaries
• Monitor claims for timely processing of payments and rejections and work A/R on a weekly basis
• Perform claim audit review for Medicare and PDGM Medicare Commercial
• Work the Medicare/Medicare PDGM Claims Held workflow
• Maintain responsibility for Oasis reports
• Review unbilled reports for Medicare and Non-Medicare on a weekly basis
• Bill Medicare/Non-Medicare claims on a daily basis
• Review pre-post report to verify all visits have a usual and customary rate and contractual adjustment on a bi-weekly basis
• Work Medicare/Non-Medicare claim rejections
• Perform billing note entry on all outstanding accounts over 30 days
• Make insurance calls to check status on outstanding claims
• Process requests for additional information from Insurance Companies
• Answer billing queue calls
• Collect patient payments via the phone
• Work monthly Medicare, Medicare, HMO, and 3rd-party agencies
• Review Monthly SOX report to ensure every account over 30 days has a Billing note
• Cover department when other employees are ill or on vacation
• Duties may vary depending on which insurance team the employee is on
• Comply with Company’s Core Values and Core Competencies
• Perform other duties as assigned by supervisor

Customer Support Specialist, I

Quality Assurance Registered Nurse

Home Health Billing Analyst I