SHMG Business Operations Support Specialist

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Job title: SHMG Business Operations Support Specialist

Company: Saratoga Hospital

Job description: Summary of Position:This job description provides information essential to understanding the scope of the position and is not intended to be an exhaustive list of skills, efforts, duties, responsibilities or working conditions associated with the position.Provides clerical support to revenue cycle staff to ensure encounters are created accurately and timely for providers and coding staff in a non-patient facing environment to enable staff to accurately code and bill for rendered services. Provides support for provider enrollment with commercial and governmental payers by assisting with the application process and tracking of information. Assumes responsibility for maintaining confidential patient information. Provides additional support to Medical Records to assist with overflow as needed.Primary Job Responsibilities:These requirements are representative, but not all-inclusive, of the knowledge, skill, and ability required of the position. Primary job responsibilities constitute approximately 90% of the positions work. To be successful, individuals must be able to perform each essential responsibility satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions outlined in this position description.

• Encounter Registration: Create open encounters for multiple assigned locations in the EMR in a timely manner. Encounters will be created using billing sheets, dictation reports, or via the use of scheduled worklists to ensure all encounters are accounted for. When appropriate, pre-selected ICD-10-CM and CPT codes will be entered into the encounter. Will validate all demographics, insurance information, location of services, and rendering and supervising providers when creating the encounters. Status of encounter will be set as appropriate for each location as directed by policy and procedure
• Coordinate with providers and/or coding staff on errors or discrepancies as needed
• Provides support to the Pre-Bill Operations team
• Position may require contact with a specific payor, provider, or patient to resolve an edit.
• Adheres to data entry guidelines by payer type and billing area.
• Verifies insurance eligibility via system, website, or phone.
• Identifies registration edit issues, data entry problems and/or educational opportunities to reduce denials and optimize reimbursement.
• Maintains confidentiality and uses discretion when handling patient information.
• Communicates quality and/or compliance issues to management.
• Meets productivity and quality standards as assigned by management.
• Participates in department meetings and training as assigned by management
• Assists credentialing staff with maintenance of tracking spreadsheet, preparation of new provider packets in order to obtain signatures for the application process, renewal of existing providers in the CAQH database. Provide additional support as needed.
• Assists management with quality assurance as needed
• Other duties as assigned

Additional Responsibilities:

• Must be attentive to detail
• Ability to participate in peer interviewing process.
• Medical record distribution/requests/smart log
• Provides communication via faxing, telephone and computer.
• May be requested to serve as a float or provide coverage in another department
• Ability to support clinical and medical staff as appropriate

Minimum Qualifications:Education, Training & Experience:

• High School diploma or GED. Previous customer service experience required. Previous medical office, coding, or billing experience preferred.

Certifications / Licensure:

• Medical terminology, coding, or billing certificate preferred.

Required Skills, Abilities and Attributes:

• Physician Practices: may be requested to serve as a float or provide coverage in another SHMG office.
• Ability to organize and establish day-to-day priorities while utilizing critical thinking skills in all aspects of the job.
• Must be able to multitask while remaining professional, focused, composed, and positive.
• Excellent customer service skills and must display integrity, friendliness, and compassion
• Must be able to establish an appropriate and effective rapport with patients, co-workers, and medical staff.
• Must be able to demonstrate effective and appropriate written and oral communication skills.
• Ability to take and follow directions in a positive and appropriate manner.
• Must be flexible
• Takes initiative and embraces new opportunities to grow both personally and organizationally.
• Must be efficient and effective in the use of resources.
• Basic computer skills.

Expected Pay Range: $19.96-$32.77/hr

Expected salary: $19.96 – 32.77 per hour

Location: Saratoga Springs, NY

Job date: Fri, 06 Jun 2025 02:05:45 GMT

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