Physician Services Resume Samples

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T Morar

Taryn

Morar

583 Shanahan Extension

Chicago

+1 (555) 843 3360

583 Shanahan Extension

Chicago

Phone

p +1 (555) 843 3360

Experience Experience

Philadelphia, PA

Manager of Physician Services

Philadelphia, PA

Wyman-Rath

Philadelphia, PA

Manager of Physician Services

Manage and track PHP CME/License reimbursements through Concur and oversee management of CareNow MCCHUC, and DRUC APP reimbursement requests
Assists in ensuring physician and APP files are complete
Oversee and develop the on-call pager system that rotates weekends
Assists Regional Medical Directors in daily functions of administrative services
Maintain and distribute physician roster to physicians and managers weekly and oversee maintenance and distribution of the CareNow APP roster
Monitor and make policy changes in PHP handbook
Assist physicians with coverage in emergency situations

Houston, TX

Director, Physician Services

Houston, TX

Roberts and Sons

Houston, TX

Director, Physician Services

Identify and facilitate the assessment and contracting process for small physician practice acquisitions
Initiate recruitment efforts with physicians in local residency programs
Direct, organize and coordinate all aspects of candidate itineraries, agendas and site visits including: travel and hotel reservations, clinic, hospital and community tours, appointments with physicians, lunch/dinner reservations, interview appointments. May escort candidates through their interviews and visit
Provide continued assistance to new hire physicians in becoming acclimated to the community during their transition/relocation. Contacts new hires after 30 and 60 days to determine satisfaction with the process and assess opportunities for improvement
Source, Screen, and negotiate employment agreements with Physicians joining DMG
Advertise open job positions and identify effective sourcing mechanisms
Develop relationships with medical training programs for recruitment purposes

present

Philadelphia, PA

Senior Director, Physician Services

Philadelphia, PA

Wisoky-Marquardt

present

Philadelphia, PA

Senior Director, Physician Services

present

Provides day-to-day management and/or operating oversight to practice managers and medical directors
Develops and implements a vision and business/operating plans targeted to promote the growth and enhancement of physician services. In this regard works in partnership with the organization’s leadership to enhance the future affiliation and integration of physicians
Manages personnel and oversees the professional development of the physician and administrative leaders responsible for the operations of physician services
Upon establishment of a Management Service Organization, MSO, directs the MSO and oversees the provision of MSO services for selected independent physician practices
Adept at working in a highly complex matrix management environment within an integrated delivery system
Establishes physician compensation and benefit programs under the guidance of the Physician Compensation Committee and the Professional Affairs Committee. Oversees the short and long term execution of those plans
Develops and implements physician service standards and operating systems to enhance the effectiveness of physician services including information management, office management, scheduling, patient service and other operating improvements

Education Education

Bachelor’s Degree in Communication

Georgia Southern University

Bachelor’s Degree in Communication

Skills Skills

Strong budget, financial and statistical analysis skills and ability to interpret information to staff and providers
Ability to examine and re-engineer operations and procedures
Knowledge of negotiations and change management
Able to express opinions openly and honestly and provide feedback in a timely and productive manner
Ability to examine and re engineer operations and procedures
Demonstrate ability to listen well and gain consensus
Experience in planning and execution. Knowledge of negotiations and change management
Ability to work independently and set priorities under minimal supervision
Ability to work within the defined values, mission and vision of the organization
Ability to work within the defined values, mission and vision

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Sutter Physician Services Resume Examples & Samples

AIM
Hospice
Labor and Delivery
OBGYN

Sutter Physician Services Resume Examples & Samples

Ability to navigate various computer programs/software
Technical Certificate in medical billing/coding, Medical Assisting, and/or medical terminology
At least 1 year of clinical experience in one of the following areas: advanced chronic illness, palliative care, hospice care (other home care based experience may be considered in lieu of hospice)
Knowledge of state and federal hospice and home health regulatory guidelines

Director of Physician Services Resume Examples & Samples

Significant progressive project management, human resources, business development and recruitment experience in a large healthcare organization and related leadership experience (6+years)
Effective, facilitation, and presentation skills; strong interpersonal, written and oral communication, problem solving, analytical and teambuilding skills
Ability to communicate and influence change effectively in both written and oral form and to convince others to take action; demonstrated management and leadership ability to lead professionals and manage others through influence and collaboration
Proficient with PC applications and internet usage
Firm grasp of the issues and challenges facing physician groups and committed to creation of a truly integrated group with decentralized leadership; exceptionally skilled in matters requiring good judgment and discretion, especially in dealing with highly confidential or sensitive information

Refunds Representative, Physician Services Resume Examples & Samples

Examine the credit balances for one or more clients
Run monthly credit balance reports
Research, analyze, and successfully resolve a credit balance to completion
Communicate with insurance companies and occasionally patients
Comply with Cash Applications department policies and procedures
Maintain productivity and quality standards set by the Cash Applications Supervisor
Meet deadlines set by the department and the company
High School Diploma or General Education Degree (GED) required
Basic skill level using Microsoft applications: Word, Excel
Must be have effective oral and written communication skills
Ability to operate effectively as a team member and be able to manage time constraints monthly
Medical Billing experience helpful, but not required

Administrative Director Physician Services Resume Examples & Samples

Minimum of five years of progressive practice management experience within a health care system required. Certification as a Medical Practice Executive (CMPE) strongly desired
Knowledge of ambulatory care
Background in clinic procedures including schedule management, registration, use of electronic medical record, patient flow, billing and referrals and authorizations
Computer proficiency including knowledge of Microsoft Office software and in-depth knowledge of electronic medical record and billing software applications
Excellent written and oral communications skills necessary
Must have superb interpersonal skills and be able to handle difficult conversations effectively
Demonstrate ability to listen well and gain consensus
Experience in planning and execution
Knowledge of negotiations and change management
Must have excellent critical thinking and problem solving skills
Able to express opinions openly and honestly and provide feedback in a timely and productive manner
Ability to examine and re-engineer operations and procedures
Strong budget, financial and statistical analysis skills and ability to interpret information to staff and providers
Demonstrates flexibility to accommodate changes in workload assignments and react calmly and effectively in stressful situations
Ability to work independently and set priorities under minimal supervision
Ability to work within the defined values, mission and vision of the organization

Supervisor, Physician Services Resume Examples & Samples

Interview candidates for open positions within team structure
Prepare performance evaluations and action plans to document and communicate individual staff and Team Lead(s) performance
Perform quality assurance checks and monitor team work loads and productivity
Conduct meetings with staff members to deliver results related to productivity and quality; discuss coaching and development needs
Compile consistent reporting statistics to document team performance
Examine reimbursement and denial patterns within assigned AR; recognize trends, suggest and implement innovative solutions
Assess opportunities to improve internal workflows; ensure best methods and tools are utilized
Maintain strong client relationships; address issues/needs delivered by client and provide accurate feedback to both client and Conifer departments
Ensure all team members adhere to internal Conifer policies/procedures

Senior Director, Physician Services Resume Examples & Samples

Provides day-to-day management and/or operating oversight to practice managers and medical directors
Manages practice sites within state and federal regulatory guidelines
Leads the quality experience initiatives for physician service operations
Ensures the existence of state-of-the-art systems for tracking, evaluating, and communicating patterns in care delivery through which clinical value to the community and payors can be demonstrated
Participates as a team member of the Senior Leadership Team orchestrating the development and integration of the patient care experience across the organization
Follows organization guidelines, negotiates local equipment and lease contracts for assigned areas of responsibility
Prepares capital requests to be modeled by finance by working with the management team and physicians
Partners with site Medical Director to develop practice-specific annual budgets
Masters degree and/or advanced professional credentials or 5 years of practice management engagement leadership/management (40+ doctors) at Senior Director level
Five to eight years experience at a senior level managing physician practices and preferably healthcare system physician group practices with a sizable employed physician base
Demonstrated superior client leadership
Prior experience with Physician Practice Management or Physician relations
Proven experience developing and implementing operating plans, and analyzing financial and quality data; experience in developing and/or operating management service organizations beneficial
Ability to implement centralized processes in a large complex environment
Proven physician relation skills
Proven commitment in a team setting, and ability to serve as a member of the Clinic management team
A proven leader in demonstrating how to build a partnership between physicians and administration
Proven communication skills, including listening and presenting
Proven knowledge of how to get things done in a complex organization
Ability to facilitate and lead successful outcomes on such matters as physician compensation that is mutually satisfactory to all stakeholders
Proven success as a team player who can build collaborative relationships across the organization
Ability to understand value of technology and able to address issues of costs, benefit/risk analysis
Ability to motivate others
Proven ability to handle complex, ambiguous and changing environments

Physician Services Analyst Resume Examples & Samples

Assists CFO – Physician Services with building and maintaining relationships with the Physicians, Facility Executives and Executive Team
Assist others in the basic usage of Business Analysis tools and core techniques
Work collaboratively with stakeholders to identify project objectives, scope, dependencies and risks for projects
Collaborate with peers to develop a customized business analysis approach, defining the business analysis tasks, resources, and estimated effort to complete a project
Communicate the approach and work with project team to modify and ultimately gain approval for the analysis activities
Manages changes to the solution requirements, assessing the impact of requirement changes, and ensuring appropriate approval of those changes
Manage solution requirement communication, ensuring that stakeholders have a shared understanding of the requirements
Work as liaisons among stakeholders in order to elicit, analyze, communicate and validate requirements for changes to business processes, data, policies and information systems
Quickly understand business problems and opportunities in the context of the requirements, analyze and present solution options
Leverage and continually mature interview and facilitation techniques to elicit business needs and requirements. Develop and/or maintain contract summary sheets, ad hoc utilization or contract value reports; maintain and update documentation
In coordination with the CFO – Physician Services, develops credible metrics and internal/external benchmarks in order to measure performance against "goal."
Helps develop physician report cards and other data/reporting in order to support Acadia's objectives with respect to development of value-driven, physician incentives
Work collaboratively with CFO – Physician Services to identify project objectives, scope, dependencies and risks for projects
Develop reports for use within the company in order to help the care team target the right preventative medicine priorities and identify gaps in care, medical errors and quality issues
College degree or equivalent experience
Three to five years’ analyst experience within healthcare industry, industry or equivalent combination of both experience and education
Expert level skills with Microsoft Office and Excel
Knowledge of data management systems
Knowledge of structured programming and database management/design
Ability to interpret, draw conclusions, and summarize financial and clinical information
Excellent communication skills, especially written, and the ability to concisely summarize

VP, Physician Services Resume Examples & Samples

Develop and implement specific programs, products, and services to support the long-range strategic direction for Physician Services
Serves as communication liaison with Group and Facility hospital leadership, Physician Services field management and physician practices
Oversees the coordination of operational start-up for new practices both newly recruited and in market acquisitions
Monitors all physician employment agreements and professional services agreements and manages contract provisions, updates, and revisions
Coordinates the HSC Practice Operations support resources to enhance practice performance and export best practices across all markets
Conducts as needed on-site practice visits to meet with Facility leadership teams, physicians and staff. Coordinates any operational opportunities with the respective leadership teams
Oversees and directs administrative functions to maintain accurate and comprehensive files for: patient records; current operational policies and procedures; internal and external reports and correspondence; governmental and regulatory standards
Provides recommendations for operational changes and ensures implementation and adherence
Identifies and recommends corrective action for organizational and/or operational improvement opportunities
Coordinates the preparation of the annual Physician Services operational and capital budgets and monitors the allocation of funds and expenses. Reviews financial and operational reports for budget variances and implements timely corrective action plans
Coordinates with Group and Facility leadership on all physician recruitment and provider manpower planning. Supervises the HSC recruiting resources to assist Facility’s in meeting medical staff development plans
Routinely conducts MORs with the Facilities and Physician Services field leadership
Regularly reviews financial and statistical reports for compliance with the Company’s SOX controls and as required attests to accuracy of same
Reviews coding and reimbursement performance data and addresses any compliance issues
Practice and adhere to the "Code of Conduct" philosophy and "Mission and Value Statement" of the Company
Maintains professional growth and development through seminars, workshops and professional affiliations to keep current with practice management trends and requirements. Actively participate in MGMA regional and national conferences
Displays consistent behavior that enhances the public image of the organization as evidenced by professionalism in interactions with peers, subordinates, customers, (patients, families, physicians, payors, vendors, etc.)
Provides ongoing orientation, identifies and coordinates staff training for new and existing employees,
Conducts performance evaluations and any necessary corrective disciplinary action with staff
Maintains strictest confidentiality in the areas of patient, employee, and physician relations

Senior Consultant, Physician Services Resume Examples & Samples

Provides day-to-day management oversight to practice managers and medical directors
Monitors operations within each practice site to ensure that patient access meets defined standards and that daily service is customer-focused
Consistently administers human resources policies and procedures throughout all practice sites. Partners with site Medical Director to develop practice-specific annual budgets
Collaborates with other members of the operations and financial team to deliver consistent, fiscally responsible, and constantly improving quality care
Minimum of 4 years professional experience Project Management or experience in a medical office setting
Demonstrated experience with managing multiple medical practices simultaneously
Previous experience working within a health system environment, while not required, is preferred
Proven ability to be a creative an innovative thinker

Consultant, Physician Services Resume Examples & Samples

In conjunction with other members of the senior management team, develops an operational plan that establishes clearly defined performance standards, metrics and workflows that can be tracked against timelines to evaluate the organization's performance at all times
Minimum of 2 years professional experience Project Management or experience in a medical office setting
Ability to develop computer work sheets and presentations

Manager, Physician Services Resume Examples & Samples

Project Delivery: With oversight from Director, responsible for effective engagement execution including: (1) manages project plan with defined scope, (2) meets projected benefit/savings for the client, (3) defines roles and manages project team, (4) anticipates, resolves or appropriately escalates client operational risks as they arise
Leads and focuses team efforts in data gathering and analysis by ensuring efficient data collection, instruction on analytical choices and formulating conclusions and recommendations
Provides leadership to both internal and client personnel to identify, quantify, implement and measure specific improvement initiatives, based on Agreement Letter
Leads delivery of client results for the project by effectively focusing team, adapts methodologies as appropriate to client situations and ultimately ensures results align with client expectations
Collaborates with client management and executives to understand and resolve client problems or barriers and provide appropriate business recommendations
Leads collaboration with other Quorum teams in order to provide seamless support to the client
Leads project planning, organizes and schedules resources. Monitors project budgets and ensures compliance with internal policies
Communicates effectively with all levels of client leadership (including C-suite, as appropriate) and establishes and maintains the relationship with the client’s designated Physician Services contact
Manages effectively to achieve Project Milestones in all work streams and appropriately escalates issues and risks to Physician Services Director
Presents project topics to client executives and physicians; possesses deep functional and operational knowledge
Possesses strong communication skills (written and verbal)
Effectively synthesizes complex data/information into key messages
Able to generate high quality analysis and effectively delegate these activities to others (e.g. Consultants, Associates)
Demonstrates strong project management skills and ability to proactively manage issues/risks
Demonstrates solid understanding of Physician Services Methodologies/Approaches and is able to execute them
Delivers client reports within 30 days of an exit conference
Develops and implements tools, training, methodology or other programs for the practice / solution
Participates in the development and/or facilitation of internal training programs
Participates in or leads other ad-hoc initiatives (all team calls, innovations, etc.)
Actively participates in the team or practice interview process contributing to the identification and hiring of key talent for the organization
Creates an effective work environment by setting a positive tone, establishing performance expectations, and driving accountability through motivation
Models integrity
Provides career coaching to assigned coachees outside of projects, if applicable. Effectively directs, coaches, motivates and evaluates staff on engagements. Ensures compliance with Quorum administrative policies by staff
Supports the on-boarding of new hires into the solution team by serving as a peer contact and connects with new employees regularly during their first several months with the team
Proactively addresses and documents performance issues

Physician Services Group Analyst Resume Examples & Samples

Mature understanding of clinical application support processes and workflow, ambulatory EMR preferred
Demonstrated analytical skills and ability to solve problems
Basic PC troubleshooting skills
Understanding of physician needs and practice patterns and workflow in facilities
Ability to establish and build strong relationships among facility leadership, physicians, and end-users

Division VP of Physician Services Resume Examples & Samples

Knowledge of organizational policies, procedures, systems and objectives
Knowledge of HCA Physician Services products and services
Skill in planning, organizing and supervising
Skill in exercising initiative, judgment, problem solving, decision-making
Skill in developing comprehensive reports
Ability to research and prepare comprehensive reports
Five years of practice management experience is preferred
Experience in managing multiple physician practices across a wide geographic area is preferred

Reimbursement Specialist, Physician Services Resume Examples & Samples

Research and obtain required documents to resolve misdirected payment issues
Cerner Experience a plus
Understanding of government payers and other commercial/managed care carrier rules and processes in a professional billing environment
Initiative to learn new tasks and the ability to apply acquired knowledge to future duties

Marketing Coordinator Physician Services Resume Examples & Samples

Bachelor’s degree required; MBA or MHA preferred
Excellent communication skills and fluency in English required
Bilingual, English/Spanish preferred
2 years related marketing experience in healthcare or related industry required

Director, Physician Services Resume Examples & Samples

Manage a comprehensive physician recruitment program to ensure an adequate complement of physicians in accordance with the needs and goals of DMG
Assess the immediate and long-term need for physicians and services for the medical group; and develops strategies for attracting a proper mix of healthcare practitioners to the area
Identify and facilitate the assessment and contracting process for small physician practice acquisitions
Initiate recruitment efforts with physicians in local residency programs
Direct, organize and coordinate all aspects of candidate itineraries, agendas and site visits including: travel and hotel reservations, clinic, hospital and community tours, appointments with physicians, lunch/dinner reservations, interview appointments. May escort candidates through their interviews and visit
Provide continued assistance to new hire physicians in becoming acclimated to the community during their transition/relocation. Contacts new hires after 30 and 60 days to determine satisfaction with the process and assess opportunities for improvement
Stays current on regional and national physician hiring trends and practices; researches competitor's activities to keep informed of changes impacting DMG's ability to hire and retain top physician talent. Provide input to improve physician-related processes
Source, Screen, and negotiate employment agreements with Physicians joining DMG
Advertise open job positions and identify effective sourcing mechanisms
Develop relationships with medical training programs for recruitment purposes
Facilitate the onboarding and orientation process for new physicians
Ability to build relationships with others and gain buy-in for implementation of recruitment process
Ability to effectively present information and respond to questions about DMG from individuals and groups of individuals
Working knowledge of healthcare administration, communities and clinic sites
Required knowledge of Microsoft office
Excellent communication skills both verbal and written and the ability to speak publically
7-10 years recruiting experience in health care with a focus on Physician or Executive recruitment

Director, Physician Services Resume Examples & Samples

Develops and implements a vision and business/operating plans targeted to promote the growth and enhancement of physician services. In this regard works in partnership with the organization’s leadership to enhance the future affiliation and integration of physicians
Upon establishment of a Management Service Organization, MSO, directs the MSO and oversees the provision of MSO services for selected independent physician practices
Manages personnel and oversees the professional development of the physician and administrative leaders responsible for the operations of physician services
Establishes physician compensation and benefit programs under the guidance of the Physician Compensation Committee and the Professional Affairs Committee. Oversees the short and long term execution of those plans
Develops and implements physician service standards and operating systems to enhance the effectiveness of physician services including information management, office management, scheduling, patient service and other operating improvements
Leads the physician employment initiatives conducting group practice assessments and other due diligence processes and recommends employment offerings
Participates in payor contract negotiations and contract compliance activities for physician services
Participates in risk management related activities targeted to proactively minimize risk and promote the safety of patients, families, employees and others
Participates as a team member of various teams to create innovative solutions associated with the provision of medical care and the strategic development of physician leaders
Serves on the Board of Trustees, committees and groups associated with physician services and physician leadership development
Participates in regional and nationally based physician administrative forums and educational programs
Prepares monthly operations report and presents results to management, physicians and committees
Oversees the establishment of internal controls for compliance and develops tools to monitor controls
Consistently administers human resources policies and procedures throughout all practice sites
Monitors ongoing monthly performance and makes appropriate practice adjustments to ensure budgetary and operational success
Masters/Graduate Degree or Bachelor’s Degree in related field such as Healthcare Administration or Allied Health or related field
Minimum of 5 years professional experience
Ability to work independently with minimal or no supervision
Proven to have successfully growing and developing an employed physician model within a health system
Experience working in physician-led, integrated healthcare delivery organization a plus
Proven knowledge of various physician compensation plans, incentives and contracting arrangements
Demonstrated success in yielding unprecedented results within the area of health care operations management
Ability to communicate effectively and articulate all relevant operational perspectives
Proven engagement with physicians, and ability to provide valuable insights and logical explanations when faced with difficult questions
Experience as a successful influencer who can interact effectively with diverse groups of stakeholders such as other physicians, healthcare administration, and staff
Ability to build trust and confidence with utmost integrity
Ability to lead change and achieve support for change; builds consensus
Strong customer service-focus for patients and employees
A proven strategic thinker with ability to see big picture
Proven business acumen and analytical skills
Ability to be patient yet persistent when appropriate
Takes accountability and responsibility for own actions
Proven credibility with physician constituencies
Proven success working towards a goal(s); ability to take initiative

Physician Services Administrative Assistant Resume Examples & Samples

Answer, screen, and transfer inbound phone calls
Resolve administrative issues and inquiries; including requests from physicians to update personal information such as change of address in Exponent HR and in Salesforce
Update Position Control listings such as AMD and FMD appointments, distribute to team
Schedule and coordinate meetings and appointments
Make travel arrangements and prepare bi-monthly expense reports utilizing Concur
Assist Training Department in ensuring physician compliance with HealthStream modules
Prepares accurate and timely reports for internal staff, including monthly deficient documentation reports, which are distributed to Area Medical Directors and Facility Medical Directors
Interfaces with Director of Physician Services and Accounting, as it relates to payment of Locum Tenens staffing agencies. Maintain related invoices for use in payroll management
Assist Revenue Cycle Department with contacting physicians relating to provider hold reports
Demonstrates professionalism and compliance to company and departmental policies and procedures
Attendance requirements are based on your current role and status of position (FT, PT or PRN). Please direct attendance requirements to your immediate supervisor and/or refer to the Employee Handbook for more attendance/scheduling details/policies
Bachelor’s Degree in Business, Health Care Administration or similar field preferred
Experience in a healthcare setting
Knowledge of clerical and administrative procedures and systems such as filing and recordkeeping

Financial Analyst Physician Services Resume Examples & Samples

3-4 years of financial analysis for physican services
Proficient in Microsoft Excel, including advance functionalities
Excellent computer application skills
Understanding of EPIC or similar EMR systems
Understanding of physician compensation calculations & agreements

Director of Physician Services Resume Examples & Samples

Develops recruitment strategies to achieve required operating room (OR) utilization levels in various geographic markets
Works with managers, field employees, and executives to develop specific recruiting plans
Develops and maintains professional relationships with appropriate outside networks as a source to generate qualified applicants
Ability to create new physician relationships across multiples specialties by cold calling, in person meetings, facility tours is critical
Directs the efforts of employment agencies and search firms including negotiating and controlling employment related fees
Plans, schedules and attends industry trade shows with appropriate staff as a source to generate qualified physicians
Coordinates efforts with credentialing department once physician has agreed to utilize our facility
Oversees onboarding process of new physician into our facility including coordination of physician preference cards, case counts, case mix and block time
Coordinate with surgical staff when a new physician begins to utilize the facility
Conduct and lead development calls with operational staff to cover important details around new physician start
Attend first three days of surgery in OR when physician begins surgical cases
Coordinate and develop relationships with medical equipment manufacturers to establish a recruiting pipeline
When in territory, educate/ market to surrounding physician practices about hospital campus and capabilities
Work to recruit physicians that would consider being on staff of the hospital campus and have admitting privileges
Maintains records on recruiting activities as required
Participates in development of annual recruiting budget
Bachelor’s degree from four-year College or university; and 5 to 10 years related experience; MBA preferred
Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or governmental regulations. Ability to write reports, business correspondence, and procedure manuals. Ability to effectively present information and respond to questions from groups of employees, managers, customers and the general public
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form
Knowledge of word processing software, spreadsheet software, applicant tracking systems, Outlook, internet software
Must have good organizational skills and attention to detail
Must provide the highest levels of customer service

LPN / Ma-physician Services Resume Examples & Samples

Education:Licensed Practical Nurse degree. Certified Medical Assistants may also be considered
Licensure/Certification/Registration:Current TN LPN or be a registered or Medical Assistant certification from one of the following organizations required: AAMA, AMT, NCCT or NHA. LPN: Current BLS certification from an approved American Heart Association training center is required to be current upon hire. MA: Current BLS certification from an approved American Heart Association training center must be obtained within 90 days of hire
Equipment:Ability to operate standard office equipment

Denials Specialist, Physician Services Resume Examples & Samples

May provide internal coverage for Customer Service calls
Previous experience with medical billing systems preferred: IDX or Epic experience a plus
Ability to multi-task and work independently
Moderate skill with Microsoft Office applications: Word, Excel

Appeals Specialist, Physician Services Resume Examples & Samples

Research and respond to insurance correspondence
Maintain internal logs (Excel format)
Contact client for missing data elements or confirmation of information
Attention to detail with the ability to identify/resolve problems and document the outcome
Ability to multi-task and recognize trends to effectively work A/R

Administrative Director Physician Services Resume Examples & Samples

Minimum of five years of progressive practice management experience within a health care system required
Certification as a Medical Practice Executive (CMPE) strongly desired
Knowledge of ambulatory care; background in clinic procedures including schedule management, registration, use of electronic medical record, patient flow, billing and referrals and authorizations
Lean Six Sigma Black Belt Certification preferred or attained within six months of hire
Experience in planning and execution. Knowledge of negotiations and change management
Ability to examine and re engineer operations and procedures
Ability to work within the defined values, mission and vision

Manager of Physician Services Resume Examples & Samples

Assists Chief Medical Officer in daily functions of administrative services as needed
Assists Regional Medical Directors in daily functions of administrative services
Oversee PHP benefits
Oversee supervising physician, collaborative agreements, and face to face processes
Maintain all new hires and termed physicians in scheduling system and oversee maintenance of the APPs in the scheduling system
Maintain and distribute physician roster to physicians and managers weekly and oversee maintenance and distribution of the CareNow APP roster
Assists in ensuring physician and APP files are complete
Maintain the physician files and oversee maintenance of CareNow APP files, including filing, scanning, and entering doctor certifications in HR system
Provide reports to physicians monthly to ensure current credentials
Oversee and backup for all CareNow, MCCHUC, and DRUC providers’ home office orientation
Manage and track PHP CME/License reimbursements through Concur and oversee management of CareNow MCCHUC, and DRUC APP reimbursement requests
Ensure PTO/CME requests are approved and processed, and oversee CareNow CME time off requests
Oversee peer review process
Process open shift lists as needed basis
Assist physicians with coverage in emergency situations
Assist physicians with their monthly schedules
Create and monitor float physicians’ and locum physicians’ monthly schedules
Oversee locum approval process, maintain locum status spreadsheet, approve locum time sheets, and remain in contact with vendors
Oversee ER transfer, MD Meeting Minutes,, and MD Monthly Clinic Assessment log
Oversee employment verifications for PHP with HR information; ensure payroll receives pay related information
Oversee newsletter binder
Back-up to prepare, and responsible for distributing newsletters for PHP
Oversee and ensure the Physician Handbook and Memo Book are being maintained and updated, responsible for preparing and distributing
Create and distribute PHP memos and MCCHUC and DRUC memos as needed
Back-up to prepare agendas for MD/AMD meetings and ensure food and conference room is prepared
Enter and audit physician payroll and resolve payroll issues
Oversee monthly reports: tardy, time summary, part time hours report, hours by clinic, and FTE reports
Maintain physician bonus requirements and reports quarterly to Chief Financial Officer
Oversee and develop the on-call pager system that rotates weekends
Monitor and make policy changes in PHP handbook
Approve PHP invoices related to position
Back-up to obtain clock numbers for all physicians
Process patient withdrawal letters
Oversee and ensure new hire full time physicians and midlevels are working on DOT certification.Oversee and ensure new hire full time physicians get triplicate prescription pads ordered

Denials Specialist, Physician Services Resume Examples & Samples

Acts as liaison between the Business Office, Legal Department and outside counsel regarding outstanding litigation (i.e., Vendors)
Coordinates legal analysis for denied, underpaid and unpaid managed care accounts for legal referral; Compiles records and documentation for internal and external attorneys such as process documentation, copies of original contracts, etc. to be used in litigation
Reviews all existing documentation including but not limited to UB, IB, Explanation of Benefits (EOB), and Managed Care Contracts to verify claim balance calculation; ensures integrity in supporting documentation
Works with Legal Department to file bankruptcy notifications on payers. May file liens on auto accident patients to state interest in claim
Verifies in system that accounts have been adjudicated correctly once settled. If needed, adjust accounts per Legal request
Works required reports (daily, weekly, monthly) to ensure legal payer issues are referred in a timely manner
Intermediate writing skills
Intermediate Microsoft Word and Excel skills
Intermediate analytical and math skills
Ability to coordinate accounts and record detailed information
Ability to research and work independently
Ability to work in high volume environment at a fast pace
Ability to communicate in a professional manner