Professional Relations Specialist

Job Details:
Position Summary: Performs a wide range of duties including developing and implementing training programs for physicians, clinicians, physician staff, administrative staff and the Central Business Office (CBO), to ensure professional revenue maximization within regulatory and contractual guidelines. Duties also include presentations to physicians, clinicians, physician staff, administrative staff and CBO for educational purposes relative to coding and medical billing requirements.

Position Qualifications: Bachelor's degree in business or health care administration and 3-5 years of progressively responsible experience in billing and accounts receivable activities for a physician organization. Thorough knowledge of all third party professional requirements, including Blue Shield, Medicare, Medicaid, commercial insurers and HMOs/PPO's. Knowledge of all industry standard practices, including the CPT procedural coding system, the ICD-9 diagnostic coding system, national HCPCS codes, third party reimbursement policies, etc. Exceptional interpersonal skills for interacting with physicians, clinicians, clinical department administrative staff, representatives of federal and state agencies and insurance agencies, attorneys, collection agencies and a large staff of employees. Considerable financial and analytical skills to analyze and respond to trends in health care reimbursement. Excellent written and verbal communication skills.