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ProMedica

CBO Specialist II - Remote

Posted a day ago
$32240 - $58448 per year
2-5 years experience
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AI Summary

The CBO Specialist II facilitates accurate professional billing, posting, and collection while managing denied insurance claims. They are responsible for identifying payment trends, appealing denials, and ensuring clean claim submissions by monitoring payor policy changes.

Location:

Junction Building - HQ

Department:

PPG CBO

Weekly Hours:

40

Status:

Full time

Shift:

Days (United States of America)

Job Summary:

As the Central Business Office (CBO) Specialist II, you will facilitate accurate professional billing, posting and collection for ProMedica Physicians and other supported entities. 


You will be responsible for accurate and timely follow up on denied professional insurance claims and be responsible for identifying trends with payors and/or procedures that are resulting in inaccurate payments, denials, or coding, and escalating within the proper departments for resolution.  You will be responsible for accurately appealing denials within appeal limits of each payor to ensure reimbursement as contracts allow.  You will be responsible for monitoring changes in payment policies by payors to ensure we have accurate edits in place within the Practice Management system for clean claim submissions. 


In this role, you will perform a variety of registration, billing, follow-up and collection functions for all payors, including self-pay. 


The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive. 


REQUIRED QUALIFICATIONS 

  • High school diploma or equivalent. 
  • Experience reading and interpreting payor Explanation of Benefits. 
  • Experience navigating insurance payor websites for information, including, eligibility, claim status, and payment information. 
  • Experience with insurance appeals and interpreting insurance payment policy.
  • Three (3) to five (5) years insurance follow up experience in a physician practice or physician billing setting.

Salary Range - $32,240 - $58,448   


We offer a competitive benefits package with coverage effective day one of employment which includes medical, dental, vision, company paid life insurance, paid time off, a 401k retirement plan, an employee assistance program and other voluntary coverage options and employee discounts.


This is a remote position; however, employment is limited to residents of certain U.S. states due to legal, tax, and regulatory requirements.  At this time, we cannot offer employment to individuals residing in California, Colorado, Hawaii, Massachusetts, New Jersey, New York, Oregon, Pennsylvania, Washington, or U.S. territories.  Eligibility is based on applicant’s primary residence at time of hire.

ProMedica is a mission-driven, not-for-profit health care organization headquartered in Toledo, Ohio. It serves communities across nine states and provides a range of services, including acute and ambulatory care, a dental plan, and academic business lines. ProMedica owns and operates 10 hospitals and has an affiliated interest in one additional hospital. The organization employs over 1,300 health care providers through ProMedica Physicians and has more than 2,300 physicians and advanced practice providers with privileges. Committed to its mission of improving health and well-being, ProMedica has received national recognition for its clinical excellence and its initiatives to address social determinants of health. For more information about ProMedica, please visit promedica.org/aboutus. 

Benefits:

We provide flexible benefits that include compensation and programs to help you take care of your family, your finances and your personal well-being. It’s what makes us one of the best places to work, and helps our employees live and work to their fullest potential.

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@promedica.org


Equal Opportunity Employer/Drug-Free Workplace

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