Mission Statement and Core Values

Athletico’s sole purpose is to provide exceptional, progressive, and cost-effective fitness, performance and rehabilitative services through personalized care that emphasizes education and prevention of future injury.  This is accomplished through building on our core values of patient/client satisfaction, accountability, teamwork and continuous improvement which are the foundation for our unique culture.

Position Summary

The position provides billing/collection support to all departments within the Billing Center. The role accurately and timely contributes to the execution of all Billing processes. This position communicates with internal departments, patients and external vendors in order to accomplish optimum outcomes.

Essential Duties and Responsibilities

• Provide customer service both internally and externally
• Capture accurate clinician demographic and clinic information in a timely manner
• Retrieve, match and submit appropriate clinical documents in order to achieve optimum collections
• Troubleshoot unmet protocols in order to capture all Industrial Rehabilitation (IR) and Auto charges daily
• Update applicable databases and websites
• Communicate with clinicians, patients and external customers in order to comply with billing, credentialing, government and refunding protocols
• Research overpaid account activity in order to problem solve and execute
• Refile claims when  inappropriate payment and denials are received
• Collect, sort and log daily batches on spreadsheets
• Research quality assurance reports in order to prevent delinquencies
• Submit legal documents to legal counsel and third party administrators timely
• Audit accounts in order to resolve line item credits and incorrect adjustments on a daily basis
• Ensure accounts are balanced properly
• Refile correct insurance which entails backing out previous contractual, posting and filing correct insurance for each date of service
• Process coordination of benefits recalculations
• Open and close batching in order to clear up deductibles, reverse write offs,  and clear balances to patients
• Maintain Billing spreadsheets
• Audit, correct and communicate clinician billing errors
• Analyze and audit the appropriateness of adjustments taken by Cash Posters and Account Receivable Representatives daily
• Audit the integrity of manual payment posting  and electronic payment posting daily
• Communicate account inconsistencies to the Cash Application Managers and Account Receivable (AR) Managers
• Troubleshoot co-pay posting errors at the request of the Account Receivable Representative or clinics
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Additional Duties and Responsibilities

• Attend department , Billing and Collection staff meetings

• Perform other duties as required
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One of the many functions of the Billing Center is to provide support to all teams throughout Athletico. The role of the Credentialing Coordinator contributes to the timely execution of all Billing processes through communication with intra company team members, insurance and governments entities.

Under the direct supervision of the Credentialing Manager, the Credentialing Coordinator:

• Provides customer service both internally and externally
• Captures accurate clinician demographic and clinic information in a timely manner
• Retrieves, and submits appropriate credentialing documentation for application submissions to insurance payers
• Troubleshoots application denials by contacting insurance payer that is rejecting credentialing application
• Updates applicable databases and websites
• Communicates with clinicians, insurance payers and external customers in order to comply with billing, credentialing and  government protocols
• Researches credentialing guidelines to facilitate and improve credentialing
• Refiles applications when returned due to missing or inaccurate information
• Collects, sorts and logs all credentialing approvals 
• Researches quality assurance reports in order to prevent delinquencies
• Submits legal documents to legal counsel and third party administrators timely
• Initiates the pathway for claims submission to insurance carriers   

Education and Experience:  The requirements listed below are representative of the knowledge, skill, and/or ability required.

• High school diploma required
• Associate’s  degree or equivalent work experience is preferred

• Knowledge of Microsoft Office, including proficiency with Excel, MS Word and Outlook

• Prior experience in data entry preferred
• Knowledge of healthcare billing systems preferred

Essential Qualifications:   To perform this job successfully, an individual must be able to perform each essential duty satisfactory. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Demonstrated ability to work effectively with both internal and external customers
• Demonstrated ability to make a clear agreement to get something done and take responsibility to achieve that commitment
• Demonstrated ability to develop personally and professionally
• Demonstrated ability to anticipates the needs of coworkers and proactively assists them to meet a common goal
• Demonstrated ability to analyze account activity in order to accurately refund patients and vendors for overpayments made
• Demonstrate the ability to actively work reports in order to prevent a delay in claims and statement processing
• Proven ability to clearly organize and effectively convey information
• Proven skill to work independently in a fast-paced environment
• Proven ability to be detail-oriented and ability to look for potential challenges while executing daily processes
• Demonstrated ability to understand and determine priorities, effectively manage time and develop work plans in order to accomplish tasks and/or projects

Language Skills

• Ability to read, write and speak English proficiently

Physical Demands:  The physical demands describe here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.

• Specific vision requirements include the ability to see at close range, distance vision, peripheral vision, depth perception, and the ability to adjust focus
• While performing the duties of this job, the employee is regularly required to talk and hear
• Possess the ability to fulfill any office activities normally expected in an office setting, to include, but not limited to:  remaining seated for periods of time to perform computer based work, participating in filing activity, lifting and carrying office supplies (paper reams, mail, etc.)
• Frequently required to stand, walk, sit, use hands to feel, and reach with hand and arms
• Occasionally lift and/or move up to 20-25 pounds 
• Fine hand manipulation (keyboarding) 
• Work Environment:  The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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• Internal office
• The noise level in the work environment is usually low
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Athletico provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.   This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.