Terms of Employment

• W2, Contract-to-Hire, 13 weeks
• The position is fully onsite in Baltimore, MD 21209

Position Overview & Responsibilities

The patient accounts specialist II prepares and follows-up all third party and patient bills, as organized and directed by the Patient Finance Manager/Director.

• Review and assess adjudicated claims for timely and proper payment of outstanding balances
• Research, correct and resubmit or reprocess unpaid claims as necessary
• Submit adjustment request daily as necessary
• Verify validity of account balances by researching, review and ensuring accuracy of charges, payments and adjustment posting and ensure account balances are assigned to the correct payer buckets
• Review and interpret Explanation of Benefits (EOB) for denials and underpayment of codes
• Research and resolve denials and underpayments with insurance carriers
• Identify payer denial trends
• Confirm insurance eligibility and confirm carrier policy for referral and auth requirements as needed for claim adjudication
• Submit carrier appeals and reconsideration request in a timely manner
• Identify and submit the required insurance refund request to refund specialist according to policy and procedure
• Meet productivity goals/benchmarks as set and communicated Department leadership
• Serve as a customer service representative for patient inquiries/calls
• Maintain confidentiality of patient information
• Work collaboratively with other departments and coworkers as needed
• Attend quarterly payer meeting with respective payers

Required Skills & Experience

High School Diploma or GED
3 years prior experience in hospital collections.
Strong payer knowledge base.
Extremely accurate with figures and data entry.
Strong analytical skill a must.
Must be able to work unsupervised.
Must be able to work with a calculator, PC and Excel
All other duties as assigned or requested.

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nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.

nTechJob

Terms of Employment

• W2 Contract-to-Permanent, 6 Months
• This position is 100% remote. Candidates must be based in Maryland, Washington, DC, Virginia, West Virginia, Pennsylvania, Delaware, New Jersey, New York, North Carolina, Florida, or Texas. Candidates based in Maryland, Washington, DC, or Virginia will be prioritized.

Overview

Our client is looking for a Data Engineer to create data extracts of various types of healthcare data and move data from “point A” to “point B”. The primary focus of this position will be on writing code. The secondary focus of this position will be on deployments. On a week-to-week basis, the Data Engineer can expect to code, attend requirements calls and project status calls, write ETL, work with Data SMEs to understand mappings, work with Testing Teams after queries have been written to test outputs, and pushing to production.

Required Skills & Experience

• Bachelor’s degree and 3+ years of IT experience – OR – High School diploma and 7+ years of IT experience.
• Highly skilled writing complex SQL queries.
• Skilled writing ETL/data pipelines using tools such as Informatica, Ab Initio, PowerCenter, Databricks, Data Factory, or similar.
• Skilled writing Python code.
• Personable with solid communication skills to attend requirements meetings with internal business teams and external vendors.

Preferred Skills & Experience

• Experience in the healthcare / health insurance industries.
• Experience working with Protected Health Information (PHI).
• Experience working in a Scrum environment.

nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.

IND15

Terms of Employment

• Contract, 6 Months (Likely Extension / Possible Conversion)
• This position is primarily remote. With that said, candidates must reside a commutable distance to Baltimore, MD (DC, Maryland, Virginia) to consider onsite work (trainings, team meetings, collaboration sessions, etc.) roughly once every three or four months.

Overview
Our client is looking for two (2) Credentialing Specialists to join the team to help support the credentialing of the new practitioners for network participation within the organization’s Behavioral Health Network. The Specialists must verify that the provider can participate in the program and accurately maintain all provider data within the enterprise-wide Provider file according to Industry Standards. This role is highly data-driven and requires meticulous attention to detail, particularly in managing and reconciling data in Excel. The ideal candidate will combine their credentialing experience with advanced Excel skills to ensure the accuracy and efficiency of the credentialing process.

Responsibilities

• Receive provider applications that they will work on from start to finish. There are twelve (12) primary source verification to complete in the credentialing file, once completed, they will take this data and enter it into the EVIP system. After the data is added to the EVIP system they will be required to complete a spreadsheet that is added to the downstream systems to claims department for approval ensuring a successful integration with the other corporate systems (most verifications are completed within 30 days, due to certain documents that may expire).
• Responds to external and internal inquiries regarding provider participation eligibility and criteria, participation status, credentialing, contractual status and provider file updates. Direct focus on the provider experience, providing timely resolution dependable follow-up and proactive measures to ensure successful credentialing is achieved. Professional etiquette, communications and sound decision making is required.
• Maintains the provider file, the Provider Information and electronic provider files with updated provider information during processes, such as credentialing, recredentialing, demographic updates, terminations and all other provider file maintenance activities.
• Responsible for identifying, analyzing and resolving immediate and existing provider file issues. Processes provider file inputs in accordance with applicable state laws and departmental guidelines. 
• Prepares written responses to obtain incomplete or missing information and or communicates effectively telephonically.

Required Skills & Experience

• 2+ years of credentialing experience in the healthcare / health insurance industry.
• Experience doing primary sourcing of credentials (licenses, work experiences, etc.).
• Experience using Pivot Tables and VLOOKUPs in Microsoft Excel.
• Experience in delegated provider credentialing.
• Highly skilled in Microsoft Office – namely Microsoft Excel.
• General clerical / data entry skills.
• Excellent written (emailing) and verbal (phone etiquette) communication skills.
• Strong customer service skills.
• Highly organized and detail oriented.
• Able to quickly learn new systems and navigate multiple portals simultaneously.

Preferred Skills & Experience

• Experience using MD-STAFF or similar provider credentialing database.

nTech Workforce is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.

IND15