Medlogix

Accountant

• Maintain and improve systems for collecting, analyzing, verifying and reporting financial information
• Participate in special projects assigned with a focus on client billing
• Collections
• Customer Billing
• Customer Reporting
• Physician Payments and Refund Processing and Tracking (Accounts Payable)
• Codes invoices, sets up new accounts, reconciles accounts, and closes the monthly books
• Reconciles bank accounts at least monthly, verifies deposits, and addresses inquiries from banks
• Reconciles customer accounts and manages accounts receivable collections
• Provides outside auditors with assistance; gathers necessary account information and documents to perform annual audit
• Enter payables and refunds into QuickBooks
• Maintains state pricing, monthly pricing and updates accordingly in platform
• Performs monthly journal entries and completes reconciliations
• Performs general cost accounting and other related duties in the accounting department
• Prepares periodic (monthly) balance sheets, income statements, and profit and loss statements
• Maintains the general ledger

Part-Time Accountant

Claims Specialist

• Responsible for reviewing and processing insurance claims by verifying policy coverage
• Gathering necessary information, evaluating claim validity, and determining the appropriate payout amount
• Interact with policyholders, agents, and other stakeholders to facilitate the claims process efficiently
• Ensure compliance with HIPPA regulations, including confidentiality
• Ability to work in multiple claim systems and provide support to multiple departments, including litigation and legal departments

Claims Processor

Manager

• Coordinate care with health care providers and insurance carriers
• Visit individuals injured in automobile and on-the-job accidents
• Maintain detailed records and documentation
• Collaborate with clients to ensure effective care management

Nurse Case Manager

Medical Billing and Coding

• Use various resources to support reviews; IE: CPT guidelines, CPT Assistant, Encoder Pro, 3M Software
• Review medical bills submitted by insurance companies related to MVA injuries sustained for NJ and or NY-covered insureds
• Interpret medical documentation ensure accuracy of billed services IE: CPT, HCPCs codes
• Assign proper CPT, HCPCs codes based on the review outcome
• Review CPT codes for unbundled services
• Review billed modifiers for accuracy of use
• Crosswalk CPT codes per regulatory requirements to ensure correct reimbursement
• Interpret fee schedule guidelines and apply those guidelines in daily reviews
• Document review outcomes for customers in a professional easy to understand manner
• Use various resources, IE: eBooks, 3M software to support reviews
• Participate in conference calls as needed with customers and/or attorneys
• Participate in virtual and in-person testimony or trial when needed
• Assist with various special projects and other duties as assigned

Certified Professional Coder, PIP Adjuster

• Responsible for the overall development and maintenance of the ancillary and facility PPO network contracts
• Contracting and rate negotiation functions
• Requires strong negotiation skills
• Understanding of healthcare contracting and compliance
• Foster and manage relationships to improve network efficiency and access for clients
• Establish targets for recruitment
• Rate negotiations
• Contract language negotiations
• Establishing and maintaining relationships
• Provider education
• In-person visits and follow-up
• Develop strategy for network expansion and maintenance
• Identify network needs in both new and existing service areas
• Investigate options, targets, and recruits
• Act as liaison between ancillary/facility and appeal department
• Negotiate rates and contract language for execution
• Assist with credentialing and recredentialing process
• Renegotiate/renew existing contracts
• Assist with development of Request for Proposals and contract updates
• Support Client Services and Sales teams

Part-Time Accountant

Claims Processor

Nurse Case Manager

Certified Professional Coder, PIP Adjuster

Ancillary Contract Manager