US Anesthesia Partners

Billing Specialist

• Provides day-to-day guidance, mentoring, and support to the RCM department
• Assists the team in resolving complex claim issues and member escalations, identifies trends, and ensures timely and effective resolutions
• Recommends and coordinates training opportunities to enhance RCM member skills and knowledge
• Identifies process improvement opportunities and participates in operational initiatives
• Collaborates with internal and external stakeholders to resolve complex issues and improve overall credit/refund performance
• Establishes effective communication channels to ensure alignment between departments
• Actively works and monitors the escalation queue to ensure timely resolution of tasks
• Analyzes escalation trends and provides real-time and scheduled feedback to team members
• Delivers targeted training and coaching to enhance team members’ understanding of escalation scenarios and best practices
• Serves as the primary point of contact for complex or sensitive escalation cases
• Creates and processes the weekly refund check utility file in accordance with established timelines and quality standards
• Assists with all refund reports and projects as needed
• Helps onboard and mentor new team members, reinforcing departmental policies and procedures
• Provides backup coverage and support to the supervisor or manager when needed.

Billing Team Leader

QA Engineer

• Conducts coder QA and education as part of identified remediation.
• Collaborates with management on development of individual or group performance improvement plans related to billing compliance or coding issues.
• Develops or reviews internal workflow or pathway directives that impact coding and charge capture to include system edits.
• Conducts coder pre-production QA and education.
• Prepares coder content and curriculums and presents coding curriculums.
• Reviews and prepares documentation for educator feedback sessions.
• Provides recommended improvements to documentation templates.
• Prepares and presents coding and regulatory updates.
• Maintains operational workflow pathways and assists coding leads as needed.
• Maintains the coding resources shared library.
• Utilizes knowledge of the revenue cycle and analyzes coding data to assist with the QA selection process.
• Assists in reviews of coding related edits and claim denials.
• Creates tracking and trend reports associated with the initiatives.
• Maintains audit software and database updates.

Anesthesia Coding QA Specialist III

Compliance

• Analyzes allowed amounts received on USAP claims for appropriateness per contract
• Reviews electronic and manual postings associated with variances
• Appeals for re-processing and requests corrections as necessary
• Identifies and resolves payer issues that negatively impact receivables
• Frequently communicates with various departments and insurance companies
• Requires independent thinking, problem solving, and strong analytical skills

Payer Compliance Specialist I

Recruitment

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Clinical Recruiter – Anesthesia OnCall

Accounts Receivable

• Performs advanced level work related to denial management.
• Processes and follows up on all appeal types, at an expert level, to all payers.
• Takes actionable steps to resolve open claims, as needed, including refiling or appealing claims, or resolving manual tasks assigned to AR for review.
• Works outstanding accounts receivable from assigned projects.
• Functions as an SME across multiple workflows and various payers.
• Provides peer payer and system training support.
• Identifies denial patterns and escalates to management for follow-up and/or root cause resolution.
• Makes recommendations to work queues and claim edits to improve efficiency and reduce denials.
• Reviews payer communications related to changes in medical and reimbursement policies.
• Researches payer trends identified by offshore partners to recommend training/process improvement.
• Identifies opportunities for and actively participates in process improvement initiatives.
• Maintains strictest confidentiality.
• Maintains basic proficiency with using spreadsheets.
• Maintains productivity and quality standards established by RCM.
• All other duties as assigned.

Accounts Receivable Specialist

QA Automation Engineer

• Designs and documents process automations that adhere to the principles of a well architected automation framework.
• Collaborates with key business stakeholders on process automation, translating that into technical solutions across multiple automation technologies.
• Creates and maintains automation architecture documentation including architectural diagrams, PDD, SDD, and runbooks.
• Manages and maintains the automation environment including robots and the platform technologies associated.
• Participates in full Software Development Lifecycle (SDLC).
• Conducts automation code reviews to ensure USAP governance and standards are being followed.
• Works directly with the Enterprise Architect and Senior Automation Developer to ensure that overall enterprise architecture governance and guidance is being followed at the automation development level.
• Maintains knowledge and awareness on technology trends and advancements helping ensure that USAP automation development stays competitive and secure.
• Other duties as assigned by management.

Process Automation Engineer

• Utilizes knowledge of insurance regulations, health insurance contracts, medical coding, and bookkeeping for revenue cycle support activities
• Medical coding, insurance verification, ensuring accuracy of information
• Preparing deposits, collecting, posting, and managing account payments
• Submitting accurate claims and following up on accounts
• Handles carrier correspondence and manages EOBs
• Provides customer service, verifies discrepancies, resolves patient billing issues

Billing Specialist II

• Collecting outstanding accounts receivable from third party payers
• Performing advanced level work related to denial management
• Processing and following up on all appeal types at an expert level
• Taking actionable steps to resolve open claims
• Working outstanding accounts receivable from assigned projects
• Functioning as an SME across multiple workflows and various payers
• Providing peer payer and system training support
• Identifying denial patterns and escalating to management
• Making recommendations to work queues and claim edits
• Reviewing payer communications related to changes in policies
• Researching payer trends identified by offshore partners
• Identifying opportunities for process improvement initiatives
• Maintaining strictest confidentiality
• Maintaining basic proficiency with using spreadsheets
• Maintaining productivity and quality standards established by RCM

Accounts Receivable Specialist – RCM

• Maintains practice management system by entering accurate data, verifying and updating insurance, and claims information
• Prepares, reviews, submits, and follows up with clean claims to various companies/individuals
• Collects, posts, and manages patient account payments
• Investigates rejected claims to see why denials were issued and correct claims
• Facilitates swift payment of invoices due to the organization by sending patient invoices, billing reminders, and making collection calls on outstanding balances
• Reviews and provides RCM weekly and monthly reports including productivity and financial reports
• Follows HIPAA guidelines when accessing and sharing patient information
• Provides timely and professional customer service, verify discrepancies by and resolve patient billing issues, answer questions from patients, facility staff, and third-party vendors

Billing Specialist III

Administrative Assistant

• Obtain medical records documentation needed for coding from USAP partner facilities.
• Access various hospital medical record EMR systems, and/or communicate with facilities.
• Run detailed reports from charge capture/coding platforms for KPI monitoring.
• Prepare reports for aging and KPI for coding leadership.
• Interact with and respond to physician coding documentation deficiencies.

Administrative Assistant – Coding

Business Development Rep

• Responsible for developing new client agreements and job orders
• Prospects via phone, text, email, and social media
• Reaches achievable sales and production goals set by the leadership team
• Collaborates with AOC account management and recruitment peers
• Partners with Account Executives to create strategies to land and expand accounts
• Manages activity and metrics to drive decision-making
• Attends trade conferences and in-person client meetings

Senior Manager – Business Development

• Analyzing allowed amounts received on USAP claims, to determine appropriateness per contract
• Reviewing electronic and manual postings associated with variances, appeal for re-processing, and/or request corrections as necessary for USAP to receive the full allowance per contract
• Identifying and resolving payer issues that negatively impact receivables
• Communicating with various internal USAP RCM departments as well as insurance companies
• Demonstrating a positive demeanor, professionalism, and polished verbal and written communication skills
• Meeting deadlines and handling potentially stressful situations and multiple tasks at the same time

Onboarding Specialist

• Coordinates employment requirements, including background checks and drug screenings
• Serves as a primary point of contact for new hires, providing support and guidance throughout the onboarding process
• Communicates regularly with the recruiter and other stakeholders to ensure alignment and transparency in the onboarding process
• Addresses any concerns or issues raised by new hires in a timely and professional manner
• Partners with credentialing to monitor the locum’s progress
• Initiates the new hire process for candidates and conducts welcome phone calls
• Updates and maintains onboarding data within ATS software
• Serves as a liaison between recruiters, clients, and candidates
• Escalates hiring issues or start delays to the appropriate party
• Handles details of confidential and critical nature

Clinical Onboarding Coordinator

• Maintains the practice management system by entering accurate data, verifying and updating insurance and claims information
• Handles carrier correspondence, manages EOBs, and keys payments received into the system
• Prepares, reviews, submits, and follows up with clean claims to various companies/individuals
• Collects, posts, and manages patient account payments
• Investigates rejected claims to see why denials were issued and correct claims
• Facilitates swift payment of invoices due to the organization by sending patient invoices, billing reminders, and making collection calls on outstanding balances
• Reviews and provides RCM weekly and monthly reports including productivity and financial reports as directed

Billing Specialist II – RCM

• Contacts insurance companies for status on outstanding claims
• Processes and follows up on appeals to insurance companies
• Refiles claims as needed
• Works correspondence daily
• Maintains basic proficiency with using spreadsheets
• Audits adjustment requests and completes when appropriate
• Resolves manual tasks assigned to AR for follow up
• Works outstanding accounts receivable from assigned work queues
• Meets productivity standards as set by the department
• Maintains an accuracy rating of 97% or greater on audited accounts
• Maintains strictest confidentiality
• Works to become an SME across multiple workflows and various payers
• Identifies and communicates trends to leadership
• All other duties assigned

Billing Team Leader

Anesthesia Coding QA Specialist III

Payer Compliance Specialist I

Clinical Recruiter – Anesthesia OnCall

Accounts Receivable Specialist

Process Automation Engineer

Billing Specialist II

Accounts Receivable Specialist – RCM

Billing Specialist III

Administrative Assistant – Coding

Senior Manager – Business Development

Payer Compliance Specialist I

Clinical Onboarding Coordinator

Billing Specialist II – RCM

Accounts Receivable Representative III