We’re delighted you’re considering joining us!
At Hill Physicians Medical Group, we’re shaping the healthcare of the future: actively managed care that prevents disease, supports those with chronic conditions and anticipates the needs of our members.
Join Our Team
Hill Physicians has much to offer prospective employees. We’re regularly recognized as one of the “Best Places to Work in the Bay Area” and have been recognized as one of the “Healthiest Places to Work in the Bay Area.” When you join our team, you’re making a great choice for your professional career and your personal satisfaction.
Serve as a proactive liaison between Hill Physicians Medical Group, (HPMG) physician practices, contracted ancillary facilities, PriMed Management, and associated health plans. Support practices and Provider Network Representatives by responding to inquiries, providing telephonic training and escalating issues as needed. Responsible for all directory and health plan audits. Responds to all medical record inquiries for Hill Health.
Responsibilities
- Support practices & physicians by responding to issues telephonically. Issues range from simple to complex and may include telephonic training on new products or processes ensuring the practice can perform needed tasks. Researches and resolves claims and/or access to care (auth) and billing issues. Issues are often time sensitive and must be resolved quickly to ensure timely cash flow to and compliance by the practices.
- Conduct quarterly audits, as required by health plans to ensure Hill provider data is accurate, often requiring instructing plans to modify physician listings. This responsibility directly impacts Hill Physicians membership and revenue. Must work collaboratively with outside partners to quickly validate and resolve inaccuracies.
- Manage SB137 process which includes verifying demographic information on all practices. This process is a compliance requirement.
- Respond to all medical record inquiries for Hill Health (Bay Region only). This includes compiling information from various EHR systems and ensuring appropriate sensitive information is excluded. Quality verification is paramount to ensure no inappropriate PHI is distributed.
- Other network support duties inclusive of:
- Manage provider notification process in accordance with Department of Managed Health Care regulations and HMPG guidelines.
- Act as a liaison for all provider and health plans with other internal departments, researching inquiries; processes all requests for enrollment in Hill’s electronic suite
- Resolves all call tracking issues for PAR and non-PAR providers.
Requirements
- One to three years of related experience preferred.
- Experience in a managed care organization or healthcare environment preferred but not mandatory.
- Knowledge of CPT, ICD-9/ICD-10 coding, and healthcare dialect, preferred but not mandatory.
- Strong verbal and written communication skills.
- Customer service experience highly desirable.
- Manage multiple projects or assignments simultaneously.
- Demonstrated ability to identify and resolve issues.
- Strong organizational skills and attention to detail is vital.
- Ability to work independently and as a member of a team.
- Proficient Excel and Microsoft Word.
Required Education
- High School Diploma/GED required; College degree highly preferred.
Additional Information
Hill Physicians is an Equal Opportunity Employer
Job Type: Full-time
Pay: $66,500.00 - $84,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Flexible spending account
- Health insurance
- Health savings account
- Paid time off
- Parental leave
- Tuition reimbursement
- Vision insurance
Ability to Relocate:
- Stockton, CA: Relocate before starting work (Required)
Work Location: On the road