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Client Services Operations Specialist

2 months ago

Fort Myers, Florida, United States American Oncology Management Company Full time

Position Overview:

In the role of Client Services Operations Specialist, you will work under the guidance of the Client Services Manager to enhance and uphold established operational standards aimed at optimizing efficiency within the revenue cycle and client services. Your responsibilities will include assisting with the accessioning process for clinical and pathology evaluations, managing incoming communications, and ensuring the seamless operation of third-party testing.

Key Responsibilities:

  • Serve as a vital link between the business office, clinic, and laboratory to address all customer service inquiries effectively.
  • Review and analyze medical insurance policies related to incoming shipments, utilizing the Insurance Matrix and Provider Billing Report for accurate test routing.
  • Collaborate with the Utilization Management team to secure necessary authorizations for in-house pathology testing.
  • Support the revenue cycle team by reviewing various business intelligence reports and addressing claims denials and resubmissions.

Quality Assurance and Reporting:

  • Assist in the preparation of monthly quality assurance reports and maintain a robust communication platform for both internal and external client interactions.
  • Conduct thorough reviews of test routing and volume reports on a monthly basis to ensure compliance with established standards.

Billing and Auditing:

  • Facilitate claims processing by ensuring that all laboratory reports are accurately uploaded into the electronic medical record (EMR).
  • Review pathology cases for appropriate diagnosis coding and update as necessary to align with billing guidelines.

Qualifications:

Education: High School Diploma required; Bachelor's Degree preferred.

Experience:

  • 1-2 years of experience in a medical billing or laboratory environment.
  • Familiarity with medical and laboratory terminology is essential.
  • Experience with insurance authorization and benefit investigation is required.

Core Competencies:

  • Analytical Skills: Strong problem-solving and decision-making abilities.
  • Interpersonal Skills: Effective communication and emotional intelligence.
  • Customer Service Orientation: A commitment to providing high-quality service to clients.

Technical Skills:

  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) is required.

Work Schedule: Standard work hours are Monday through Friday, totaling 30-40 hours per week.