Job description

Pediatric Associate of Hampden County

Triage Nurse, Posted 2/13/2023

Pediatric Associates of Hampden County, Inc is currently seeking a Full-Time Telephone Triage nurse at our West Springfield & Westfield location. All applicants must have reliable transportation. We require one to two Saturdays a month and one evening per week.

GENERAL STATEMENT OF DUTIES

Assesses the conditions of the patient, and determines urgency of appointment throughout the clinic day. Dispenses medical advice and consults with providers and care team as needed. Coordinates communication between office and parents, patients, pharmacies, and medical providers.

SUPERVISION

Reports to the Supervisor/Office Manager.

TYPICAL PHYSICAL/MENTAL DEMANDS

Requires sitting for long periods of time with a telephone or headset. Requires normal hearing, vision, and speech with the ability to read, prioritize, and handle multiple tasks. Requires manual dexterity sufficient to operate a keyboard, telephone, copier, scanner and other office equipment as necessary.

ESSENTIAL FUNCTIONS OF JOB

  • Answers the triage line according to protocol.
  • Checks message boxes several times a day and completes & documents requests as necessary.
  • Provides appropriate triage according to protocol (Barton Schmidt). Answers patient questions, evaluates their needs, schedules acute appointments and gives advice as needed (Provider consultation available upon request). Documents all telephone calls.
  • Prepares prescriptions & refill requests and directs to appropriate physician.
  • Calls patient to relate the provider response to test results and other medical issues.
  • May schedule diagnostic tests (US, MRI, CT Scan).
  • May process outgoing referrals as required by insurance plans.
  • May order tests and schedule appointments with specialist as provider plan indicates.
  • Documents in the chart all testing, referrals and specialist appointments ordered.
  • Contacts on-call office/provider with lab tests and patients for follow up.
  • Fax lab reports and medical records as needed.
  • Completes and sorts incoming faxes.
  • Maintain patient confidentiality.
  • Perform other duties as required by Supervisor/Office Manager/Provider.
  • Must maintain good and reliable attendance.

PERFORMANCE REQUIREMENTS

Knowledge of medical office practices and procedures. Skill in operating a computer. Greeting and interacting with patients over the telephone in a warm, compassionate and professional manner, always in a pleasant and helpful way. Ability to read and follow

oral and written instructions. Effectively organize and prioritize work. The ability to react calmly and effectively in emergency situations; communicate clearly; and maintain productive working relationships with patients, parents, staff and providers.

EDUCATION

Graduate of a Licensed Practical Nurse (LPN) Nursing program.

Benefits:

  • 401(k)
  • 401(k) matching
  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off

Interested candidates should contact Vanessa Fernandez at vanessa.fernandez@chppoc.org

Pediatric & Adolescent Medicine, Wilbraham, MA - Posted 2/9/2024

Pediatric Behavioral Health Integration Provider 

Pediatric & Adolescent Medicine, an experienced, dedicated and family-focused pediatric practice, is seeking candidates for an opportunity in pediatric behavioral health integration. Pediatric & Adolescent Medicine is a Pediatric Physicians’ Organization at Children’s (PPOC) affiliated primary care practice.

The successful candidate will become an integrated member of our provider team. Working with our practice’s family-centered medical home, the behavioral health provider will conduct clinical evaluations, deliver short-term, evidence-based, behavioral health interventions to patients and families, provide consultative support to medical clinicians and staff, and help support the medical home team in making referrals to community-based providers and services.

A master’s degree in social work or mental health counseling (LMFT, LICSW or LMHC), or doctoral level in psychology is required. Candidates must be licensed for independent practice in Massachusetts. Experience working with children, adolescents, and families is required. Experience in pediatric primary care, or other pediatric medical setting is preferred. Excellent diagnostic skills, flexible approach to work, and use of problem-focused, cognitive and behavioral interventions is highly desirable. Candidates should have a proven record of collaborative service delivery, outstanding written and verbal communication skills, ability to document within electronic medical system, and the flexibility and adaptability required to work in a very busy medical practice.

Email resume and cover letter to rglenn@pamcares.com

Medical Receptionist, Newton, MA - Posted 2/6/2024

Newton Pediatric office has a full time position available for a friendly, hardworking and dependable medical receptionist.

We are a busy Pediatric office dedicated to our patients, families and each other. The qualified candidate will be responsible for answering phones and greeting and registering patients. Other responsibilities include electronic appointment scheduling, insurance verification, patient registration, report compiling, assist with Rx refills and various other administration duties.

Required qualifications:

* Prior medical office experience preferred

* Working knowledge of EPIC, our electronic medical record software (EMR)

* Able to demonstrate proficient PC skills

* Professional phone manner and attitude

* Detail oriented and team player

* Comfortable working in a fast-paced and multi-tasking environment

* Ability to effectively communicate verbally and in writing

*Weekend availability is a requirement We offer a competitive salary and benefit package which includes paid holidays, accrued vacation and sick time, medical and dental coverage, free parking, four-day work week and a 401(k) plan eligible after first anniversary. We are also currently offering a $500.00 sign on bonus after 90 days of employment with our company.

Interested candidates should forward a resume to amandak.pnw@gmail.com

1/23/24 - Holyoke Pediatrics -- Medical Home Care Coordinator

The Medical Home Care Coordinator (MHCC) enhances patient care through a diverse role as a clinical educator, care coordinator, patient and family advocate, and quality improvement facilitator for our patients. The MHCC works in a collaborative relationship with other members of the Patient Centered Medical Home (PCMH) team to improve delivery of comprehensive, cost-effective patient and family-centered care. The MHCC plays a pivotal role in facilitating health maintenance, disease prevention, chronic disease management, and clinical evaluation of medical and psychosocial needs for the patients and families of our Medical Home. MHCC is responsible for monitoring and closing clinical gaps in care and ensuring smooth transitions of care. If interested please email Cheryl Fletcher, fletcherc@holypeds.com.

Position Qualifications Include:

  • Professional healthcare license preferred.
  • Three to five years of clinical experience preferred, preferably with a focus in disease or case management. Clinical experience working with a pediatric population preferred.
  • Bilingual preferred.
  • Strong written and verbal communication skills are required.
  • Strong critical thinking and analytical skills are required.
  • Proficient with the use of computer technology such as Microsoft Office and electronic medical record systems.
  • Ability to function independently, multi-task and prioritize effectively.

Work Hours:  40 hrs. per week      

1/23/24 - Holyoke Pediatrics -- LPN, RN, CMA: Full & Part Time

Must have current nursing license. Epic EMR experience and bilingual (Spanish) a plus. Must be able to multi-task in busy out-patient office setting. Must work effectively with providers, staff members, patients and families. Good computer skills needed. Must be able to travel to South Hadley Office as needed.

Duties will include but are not limited to:

  • Obtaining Vitals
  • Obtaining Medical Histories
  • Performing procedures such as vision screens, hearing screens, giving medications, giving immunizations, collecting lab specimens, ear washes, bladder catheterization, etc.
  • Medication Reconciliation
  • Triaging calls
  • Completing medical forms
  • Making/canceling appointments
  • Keeping exam rooms neat, orderly and stocked for providers

Interested Candidates should email resume to Elsie Dejesus at dejesuse@holypeds.com

1/11/24 - Walpole Pediatrics -- LPN

We are looking for a reliable LPN to work part time in a busy pediatric primary care office with multiple providers.  One year of pediatric experience preferred but not required. Telephone triage and EPIC experience are a plus.

Some responsibilities include:

  • vaccine administration
  • medication administration
  • assisting providers with simple procedures
  • standard vital signs
  • medication reconciliation
  • patient and family education
  • routine lab testing
  • telephone triage

Job Type: part time

Salary : $28.00 - $30.00 per hour 

Benefits : Flexible schedule, paid time off, health Insurance 

Schedule: days, evenings and weekends

Interested candidates should email kbeaton@walpolepediatrics.com or hillary.dame@walpolepediatrics.com.

1/10/24 - Children’s Medical Office of North Andover, P.C. -- BC/BE Physician

Children’s Medical Office of North Andover, P.C. (CMO) seeks a BC/BE physician interested in practicing primary care pediatrics in a medical home. Available immediately, this position could be from 0.75 to 1.0 FTE, and has future partnership potential.  

CMO is a collaborative group practice on Boston’s North Shore. We provide care to patients from birth through age 22 with a variety of socio-economic backgrounds and special health care needs. Our clinicians include 3 pediatricians, 4 pediatric nurse practitioners, and 1 on-site child psychologist. We are a founding member practice of the Pediatric Physicians’ Organization at Children’s (PPOC), have staff privileges at both Boston Children’s Hospital and MGHfC, and our physicians hold academic appointments at Harvard Medical School. There are ample opportunities to participate in teaching and PPOC QI initiatives. We use the EPIC platform for patient care documentation.

We are looking for someone with excellent clinical skills and a commitment to quality, teaching, and coordination of care.  We offer very competitive salary & benefits.  

Interested candidates please send a CV and cover letter via email to:  
Elisabeth Winterkorn, MD
Medical Director
drwinterkorn@chmed.com

12/18/23 - Roslindale Pediatrics -- Behavioral Health Clinician

BEHAVIORAL HEALTH CLINICIAN

Roslindale Pediatric Associates is a dedicated, family-focused pediatric practice located in West Roxbury. We are seeking candidates for a full-time (32-40 hours per week) position to grow our team in pediatric behavioral health integration. We are proudly affiliated with the Pediatric Physician’s Organization at Children’s (PPOC).

RESPONSIBILITIES:  The successful candidate will join our clinical staff to deliver fully integrated behavioral health services to our patients. Working within our family-centered medical home, the behavioral health provider will:

  • Provide comprehensive assessment and diagnosis of behavioral health concerns,
  • Provide effective treatment planning, consultation, and appropriate brief interventions, to help patients successfully achieve health goals,
  • Provide assistance to patients in transitioning those requiring longer-term care to an appropriate community mental / behavioral health provider,
  • Provide consultative support to medical providers and staff,
  • Actively participate in meetings and professional development that support the practices’ integrated health care model,
  • Assist in identifying patients at risk of developing health problems, and provide preventive interventions to address the needs of these populations,
  • Assist the primary care team in developing care management processes, such as the use of guidelines, disease management techniques, case management, and patient education, to improve self-management of chronic conditions,
  • Help to evolve the practices integration efforts, by identifying problems and making recommendations for improvement.

BENEFITS:

  • Medical, Dental & Vision Insurances w/ HRS & FSA
  • Life Insurance
  • Long Term Disability
  • Employee Assistance Program
  • Retirement Plan including 401k, Guaranteed 3% Safe Harbor, and Profit Sharing
  • 11 Paid Holidays
  • Paid Vacation Time
  • Paid Sick Time
  • Reimbursement for professional licensure, professional liability coverage, and some other professional fees
  • Reimbursement for approved CME credits

QUALIFICATIONS: 

  • A Doctoral or Master’s Degree in a mental health field from an accredited graduate program and a license for independent practice in Massachusetts (Licensed Psychologist, LICSW, LMHC, LMFT) is REQUIRED.
  • Experience working with children, adolescents, and families is REQUIRED.
  • Experience in pediatric primary care or other pediatric medical setting is preferred.
  • Experience in behavioral therapy, cognitive therapy, motivational interviewing, and brief, solution-focused interventions is highly desirable.
  • Candidates should have a proven record of collaborative service delivery, outstanding written and verbal communication skills, and the flexibility and adaptability required to work in a fast-paced, busy medical practice.

Qualified Applicants are encouraged to forward a resume and cover letter to:  Roslindalepeds.om@chppoc.org

12/18/2023 - Roslindale Pediatrics - Clinic Administrator /Nurse Manager

Clinic Administrator / Nurse Manager

Position: Full Time Salaried Position

General Description: Roslindale Pediatrics seeks a dedicated full-time Pediatric Registered Nurse with management experience to lead and support our clinical team. This team member reports directly to the Managing Partner. This is an in-office, salaried position. The Clinic Administrator will manage the daily clinical operations and oversee employee orientation and training. Responsibilities also include coordination of our patients’ care, including preventative care and health maintenance. This candidate should be passionate about providing patient–centered care and interested in leading quality improvement efforts to better serve the clinic's pediatric patients and families.

About Roslindale Pediatrics: Roslindale Pediatrics provides high quality, compassionate, and comprehensive health care for pediatric patients and their families in a supportive and respectful environment. We are a well-established, medium sized office located in West Roxbury, MA with 7 physicians, 5 nurse practitioners and 2 behavioral health clinicians. Our patients are newborn through college age, and many families have been with our practice for generations. 

Summary of Duties:

  • Works collaboratively with the practice’s staff, including the Managing Partner and Practice Administrator, to ensure that the overall daily operations of the practice are safe, efficient, medically sound, and patient-centered.
  • Maintains standard operating procedures (SOP) and training procedures for clinical staff.
  • Engages in educational and professional development training to enhance their ability to provide effective, efficient and quality care.
  • Is responsible for interviewing, hiring and onboarding nurses and other clinical staff.
  • Oversees scheduling of clinical staff as well as the medical home care coordinator.
  • Evaluates the performance of staff nurses and medical assistants through feedback and mentoring programs to ensure safe and efficient operations.
  • Oversees on-site clinical laboratory (CLIA waived testing) and Maintains compliance with CLIA waived testing procedures and SOP.
  • Serves as the primary liaison between Roslindale Pediatrics and Quest labs.
  • Oversees vaccine ordering, maintenance, and administrative procedures.
  • Is responsible for ordering and maintaining inventory of medical supplies.
  • Works within the PPOC community as a representative of Roslindale Pediatrics.
  • Oversees Roslindale Pediatrics’ Medical Home Care program as a member of the NCQA Medical Home Committee.
  • Strives to identify and implement opportunities for quality improvement.
  • Attends weekly meetings with staff and management team.

Benefits:

  • Medical, Dental & Vision Insurances w/ HRS & FSA
  • Life & AD&D Insurance
  • Disability Insurance
  • Employee Assistance Program
  • Retirement Plan including 401k, Guaranteed 3% Safe Harbor, and Profit Sharing
  • 11 Paid Holidays
  • Paid Vacation Time
  • Paid Sick Time
  • Reimbursement for professional licensure, professional liability coverage, and some other professional fees
  • Reimbursement for approved CME credits
  • Cell Phone reimbursement

Minimum QualIfications:

  • Maintains an active RN license with the Commonwealth of Massachusetts.
  • Possesses leadership and management skills.
  • Has a minimum of 3 years of management experience in a pediatric clinical setting.
  • Demonstrates excellent communication skills, both written and verbal.
  • Has experience with vaccine ordering and maintenance procedures.
  • Has experience with EHR, preferably EPIC EMR system.
  • Is comfortable working collaboratively as a team leader.
  • Is passionate about working directly with pediatric patients and their families.

Qualified Applicants are encouraged to forward a resume and cover letter to:  Roslindalepeds.om@chppoc.org.

12/18/2023 - Roslindale Pediatrics - Pediatric Case Manager

Job Title: Pediatric Case Manager

Reports To: Clinic Administrator

Supervises: No one

Overtime Status: Non-exempt

Job Type:  Full-Time In-Person

Roslindale Pediatrics is looking for a compassionate and organized Pediatric Case Manager to join our team. In this role, you will be responsible for the coordination of both medical and non-medical services for children with special health related considerations including chronic medical conditions, socioeconomic challenges, mental health conditions, and developmental concerns. You will collaborate with a multidisciplinary team to develop and implement care plans, coordinate appointments and services, and provide education and support to families. The ideal candidate will have experience working with children and families in a medical setting, as well as excellent communication, organizational, and time management skills.

About Roslindale Pediatrics:  RPA provides high quality, compassionate, and comprehensive health care for pediatric patients and their families in a supportive and respectful environment. We are a well-established, medium sized (7 physicians, 5 nurse practitioners, and 2 behavioral health clinicians) office located in West Roxbury, MA. Our patients are newborn through college age, and many families have been with our practice for generations.

Duties & Responsibilities

  • Serve as a liaison between patients, their families, and treatment team.
  • Keep detailed records of all contact with children and families, as well as any other pertinent information.
  • Assist families in accessing community resources and support services.
  • Help families navigate the Special Education process.
  • Advocate for children and families within the school system and community.
  • Connect families with appropriate mental health and/or medical providers.
  • Maintain confidentiality of all information pertaining to the child and family.
  • Manage care plans.
  • Follow up on positive Health Needs Assessments.
  • Conduct SSRI Follow ups.
  • Follow-up on Epic messages sent by parents/providers (Behavioral health resources, updating referrals, processing referrals to the Developmental Medicine/Autism Clinic, scheduling urgent and routine appointments for parents)
  • Performing Close-the-Loop Activities for orders and referrals placed by the medical provider.
  • Send referrals to outside facilities or BCH Liaison.
  • Update referrals sent back from BCH Liaison.
  • Meet with parents who require assistance filling out forms for resources (DMH/DDS/Intakes for services)
  • Run reports for PPOC & NCQA measures.
  • Attend quarterly MHCC Longitudinal Meetings.
  • Create/Update resource lists.
  • Complete/Update PT-1 Transportation requests.

Benefits:

  • Medical, Dental & Vision Insurances w/ HRS & FSA
  • Life Insurance
  • Long Term Disability
  • Employee Assistance Program
  • Retirement Plan including 401k, Guaranteed 3% Safe Harbor, and Profit Sharing
  • 11 Paid Holidays
  • Paid Vacation Time
  • Paid Sick Time
  • Reimbursement for professional licensure, professional liability coverage, and some other professional fees
  • Reimbursement for approved CME credits

Required Skills and Qualifications

  • Bachelor’s degree in social work, psychology, sociology, nursing or related field.
  • Minimum of one year prior experience working with children and families in a clinical setting.
  • Knowledge of child development, family systems, and psychosocial issues.
  • Ability to build rapport quickly with children and families.
  • Excellent communication skills, both written and verbal.
  • Cultural competence and ability to work with diverse populations, including families from ethnically diverse backgrounds and LGBTQ+ children and families.
  • Preferred Qualifications: Experience with Electronic Medical Records (EMR)

Qualified Applicants are encouraged to forward a resume and cover letter to:  Roslindalepeds.om@chppoc.org

12/1/23: Full-time – Behavioral Health Clinician at Children's Medical Office, North Andover

Reports To: Medical Director/Practice Manager

General Description: We seek a Behavioral Health Clinician who will work on a multidisciplinary team in a pediatric primary care setting. S/he will provide behavioral health services to patients and families within the practice’s model of the medical home. The clinician will consult with medical staff in the practice on behavioral management, and help coordinate behavioral health referrals to services outside the practice. This candidate should be passionate about providing patient- centered care and should be willing to make quality improvements to best serve their pediatric patients.

Summary of Duties:

  • Provide individual and family behavioral intervention for pediatric patients ranging from toddlers to young adults in a primary care setting. 
  • Provide short-term problem-focused interventions for the majority of patients. For some patients and their families, more moderate to intermediate length treatment may be more appropriate and therapeutically beneficial. Typical issues include anxiety, depression, ADHD, family discord, and behavioral outbursts. 
  • Evaluate children with positive behavioral health screens to determine need for further diagnostic assessment and behavioral services
  • Provide consultative support to the practice’s providers
  • Provide documentation as required for approval of behavioral health services by health insurer
  • Assist with administrative tasks and oversight of the department (including ensuring compliance with insurance requirements for session notes, treatment plans, supervision, treatment authorizations, RBT requirements, etc.)
  • Engage in various educational and professional development training to enhance ability to provide effective, efficient and quality care. We also specifically ask that the provider actively participate in provider/staff training via in-house educational sessions at provider rounds to enhance coordination of care and understanding of the intersection between medical and behavioral health issues.

Minimum Qualifications:

  • Has a Doctoral degree in psychology from an APA–accredited program (PhD or PsyD) or a Master’s degree in Social Work or Mental Health Counseling from a CSWE–accredited program
  • Is currently licensed in Massachusetts at the independent practice level
  • Has experience with and comfortable working on a team
  • Has a minimum of 3 years clinical experience working with children and families
  • Has an understanding of “behavioral health integration in primary care” and the “medical home”
  • Has experience with EHR (electronic health records) and an overall comfort with computers and health-related software

Preferred Qualifications:

  • Has experience with the EMR system Epic
  • Has experience as a case coordinator and local resources.

11/20/23:  updated OPEN JOBS for Woburn Pediatric Associates, LLP

Woburn & North Andover Pediatrics is seeking qualified candidates for the following positions:

  • LPN/RN – Woburn & North Andover
  • Medical Assistant/CMA – Woburn & North Andover

Woburn Pediatric Associates, LLP is made up of Woburn Pediatric AssociatesNorth Andover Pediatric Associates, and our integrated behavioral health practice Woburn Pediatric Psychological Services (WPPS) and WE ARE HIRING! 

We are 30 providers strong between our two locations and have an exceptional support staff that contributes to the comprehensive care our diverse patient population receives from our providers. Our convenient on-site lab, nutrition consultant, integrated behavioral health clinicians, medical home care coordination and an internal behavioral health practice also contribute to our well-rounded patient-centric private practice. 

If you or someone you know may be a good fit for one of these jobs, please send a cover letter & resume to Joanne Blaser, HR Manager, at jblaser@woburnpedi.com stating that they’d learned of the job via the PPOC Weekly Roundup Job Posts.

LPN/RN - Full-time – Woburn & North Andover - $2,500 Sign-On Bonus!

An integral member of our clinical team, this nurse will provide telephone triage and patient care advice to patients/families, assist providers as needed with direct patient treatments and procedures, administer immunizations to patients, monitoring for reactions and side effects, collaborate with providers to assess, plan, implement/evaluate patient care plans, order, interpret and evaluate diagnostic tests to identify and assess patient’s condition, process Rx refills and assist providers in maintaining the daily functions of the practice to ensure the highest level of service and care for our patients.

This is a full-time, benefits-eligible position and requires the ability to work a flexible 4-day schedule, every 5th/6th weekend and some shorter hour ‘minor’ holidays. The person in this role will flex between our Woburn & North Andover offices.

Qualifications:

  • current MA Nursing License, required.
  • current LPN licensure in the Commonwealth of Massachusetts; OR 2 or 4-year degree (ASN or BSN) in nursing from an accredited school of nursing.
  • 2+ years of direct patient care/outpatient experience required - previous pediatrics a plus.
  • Epic experience preferred.

Interested applicants are encouraged to apply as soon as possible via Indeed OR by sending a resume & cover letter via email to jblaser@woburnpedi.com. Please mention that you learned of this job via the PPOC Weekly Roundup Job List.

MA/CMA – Full-time – WOBURN & NORTH ANDOVER - $1,000 Sign-On Bonus!

As a member of our Medical Assistant team you’ll provide quality support to patients by assisting assigned provider(s) with the daily tasks associated with outpatient office visits: pre-visit prep, exam room readiness, and vitals/medical history updates prior to the provider exam. You will also: 

  • prepare and administer vaccinations,
  • record data collected during visit in Epic, as well as post-visit treatment & test results.
  • Coordinate post-appt tasks including the scheduling of specialist appointments and follow-up on tests & x-rays, as needed.

The full-time schedule includes 4 days during the week (between the hours of 7:30am - 6pm - schedule will be consistent from week-to-week), plus the requirement of either Saturday or Sunday shorter-hour day each weekend*.

* Must be available to work one (shorter hours) weekend day each week as our office is open for sick appts. and newborn visits – plus several shorter-hour 'minor' holidays.

In addition to the requirement of successful completion of MA/CMA-specific program (current CMA certificate a plus)we require a high school degree or equivalent. Associate’s degree/some college a plus!

Interested applicants are encouraged to apply as soon as possible via Indeed OR by sending a resume & cover letter via email to jblaser@woburnpedi.com, and mention that you learned of this job via the PPOC Weekly Roundup Job List.

Westwood-Mansfield Pediatrics is hiring a full-time pediatrician, posted 11/17/2023

Westwood-Mansfield Pediatric Associates has a current position available for a full-time Pediatrician.  Westwood-Mansfield Pediatrics is an established practice that has been serving children and adolescents for over fifty years.  The practice services about 17,000 patients and  operates in three locations; Westwood, Mansfield and Easton Massachusetts.  All sites are about 30 minutes outside of the Boston area.

The practice is owned by six (6) Pediatricians,  employs six (6)  additional Pediatricians, six (6) Pediatric nurse practitioners, three (3) Integrated Behavioral Health Clinicians and are strengthened by  approximately 60 support staff.  The practice is professionally managed with an executive director and a team of competent department managers.

The practice operates under a Medical Home Model , is NCQA Certified and its key mission is to educate and empower families. 

The practice is affiliated with Boston Children’s Hospital and is a member of the Boston Children’s Primary Care Alliance which is a co-marketing and co-branding program between Boston Children’s and a network of primary care providers in Massachusetts. The program is designed to raise awareness of and preference for Alliance partners among patients and families in local communities.   The practice is also a member of the  Pediatric Physician’s Organization of Children’s (PPOC) which encompasses over 300 pediatricians all working together to negotiate the best payer contracts in the area.  

We utilize pediatric hospitalists,  eliminating hospital rounding.  Call averages about 2-3 nights per month (Phone only) and 1:11 weekends.  First call is staffed by Pediatric Nursing Coverage with physician as 2nd call. 

Interested candidates should send a CV by email to coneill@wmpeds.com or by mail to Carol O’Neill, Executive Director, 541 High St., Westwood, MA 02090.  Please visit our Website at www.wmpeds.com for more information about our practice.

Pediatric Health Care Associates is hiring Medical Billing Manager, posted 11/16/2023

  • Monitors coding requirements and submissions to maximize revenue and comply with regulations. Annually reviews fee schedule. Keeps up to date on laws, regulations, and healthcare trends that affect the practice’s business systems and operations.
  • Takes initiative and utilizes knowledge to problem-solve issues identified within the work queues.
  • Monitors coding and denial edits and is the resource for medical billers for coding-related matters.
  • Provide and facilitate billing and coding education to practice about coding and billing best practices
  • Collaborate with coding on charges submitted by providers to ensure charges submitted represent what providers have documented for billing compliance and to provide real-time education to improve providers' billing and documentation practices and to prevent repeat errors.
  • Review processes to help prevent unnecessary denials for registration errors, and provide statistics on quality, service, and financial performance
  • Monitors the Epic work-queue denials. Frequently monitors denial reports and trends for revenue improvements.
  • Monitor and manage customer service issues, questions and complaints until resolution
  • Researches and documents any questionable item causing the denial or underpayment of claims and makes efforts to facilitate appeal, re-bill, or seek solutions for future improvements.
  • Makes deposits and collaborates with the bookkeeper regarding managing the monthly reconciliation process.
  • Manage and lead a team of six medical billers.

Revenue Cycle Performance

  • Demonstrate proficiency in operations to achieve increased collections, optimal billing goals, and adherence to compliance rules and regulations.
  • Manages department’s medical biller daily activity and productivity when working work queues and assigned tasks by manager
  • Support medical billers with training and education on streamlining and identifying ways to work efficiently and effectively when working denials, charge reviews, and charge routers.
  • Understand the implication of each element in the revenue cycle communicate this to practice to engender an appropriate response.
  • Focus practice on issues that will positively or negatively impact financial performance by reviewing coding and billing
  • Act as an internal consultant, providing essential quality reports, and advice, and improvement recommendations to the management team and providers
  • Required to understand and communicate complex issues and changes relating to industry revenue cycle and regulatory compliance, third-party reimbursement, maintaining records of their notification, accountability, and compliance.
  • Provide updates on global coding and reimbursement practice issues. Assesses the impact of new regulations or codes from a coding, compliance, and reimbursement perspective.
  • Manage the weekly open encounter report to ensure charges are submitted timely
  • Provide vision and management expertise in guiding the complete process re-engineering of professional billing, including but not limited to:

Financial Operations

  • Create operational protocols and use statistics/metrics to determine overall performance and effectiveness, staff performance and error rates, and annual review.
  • Conduct analysis, verification, and reporting of all revenue cycle-related reconciliation processes
  • Supports the integration of new physicians into the practice by providing professional charges by CPT code and assisting in the orientation/training of physicians

Revenue Cycle Reporting

  • Proactively reviews monthly reports on accounts receivable for analysis to identify trends in denials to identify areas of improvement.
  • Provides management team with statistical reports including but not limited to professional billing-related edits, service to post-date lag time, charges held due to provider credentialing, new provider charge hold, monthly write-offs, payer rejections, and claim denials.
  • Will be required to meet with Directors regularly to build consensus on strategy; rewrite departmental procedures as a result of changes, and provide statistics on financial performance

Other

  • Establishes and develops collaborative relationships with internal staff.
  • Provide continuing education to staff and providers on an as-needed basis
  • Manage weekly staff payroll/timesheet
  • Provider updates on new providers credentialing status
  • Conform to standards of performance and conduct, including those pertaining to patient rights, so that the best possible customer service and patient care may be provided.

.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee in this job. The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

Education

  • Certification as a Certified Professional Coder (CPC) is highly desirable.

Experience

  • A minimum of 5-7 years of professional billing management experience is required.
  • 3 - 5 years of Epic Revenue cycle system experience preferred

Knowledge And Skills

  • Advanced knowledge of healthcare revenue cycle functions, including coding and billing guidelines and government payer regulations. Must have CPT coding knowledge.
  • Working knowledge of payer reimbursement and rules.
  • Experienced in auditing, training, and communicating revenue cycle regulations and concepts.
  • Excellent interpersonal and communication skills to positively interact with a variety of personnel, including physicians and administrative and management staff.
  • Strong analytical skills.
  • Excellent customer service skills
  • Highly skilled experience and knowledge of Windows-based software required, including but not limited to Microsoft Windows, Outlook, and Excel.
  • Proficient skills in collecting, organizing, and analyzing data, in order to produce actionable reports and recommend improvements and solutions.
  • Possess effective oral and written skills.
  • Must be resourceful in finding the answer to any questions related to billing and coding
  • Ability to interpret and implement regulatory standards.
  • Working knowledge of Epic.
  •  Possess effective time management skills to permit handling of large workload.