Network Development Rep.

 Network Development

Austin, Texas

The following job description is a general outline of essential and common functions related to the performance of your job.  All employees of USA Quality Staffing are expected as a condition of employment to perform tasks as assigned by management whether included in your job description or not.

Supervisor

          VP – Network Development

Job Classification

          Administrative

Non-Exempt

Job Summary

Develop and build PPO, Specialty and Medicare networks for a national managed care organization.  Responsible for initiating discussions, giving formal presentations, concluding negotiations, and finalizing Agreements, Amendments, and/or Addenda for network providers and ancillary facilities.  Work with VP of Network Development and appropriate team members to develop and analyze geographic markets.  Work on a strategic negotiation plan to enhance the network provider and ancillary facility availability for both current and potential clients.

Job Responsibilities

·         Act in concert with company and departmental mission statement, objective, strategy and philosophy.

·         Utilize contracting methods within the guidelines established by the department to efficiently build network relationships.

·         Initiate discussions, negotiate rates for services and conclude contracting efforts with facilities.

·         Communicate and coordinate with all members of marketing and contracting team to effectively develop continuum of care and network referral patterns.

·         Re-negotiate reimbursement terms for services.

·         Track and report all progress accurately.

·         Prepare reports to represent marketing productivity, administrative issues, goals and objectives.

·         Adhere to USA Managed Care Organization’s Information Security Policies and Procedures

·         Adhere to HIPAA Guidelines and Requirements

Qualifications

·         Minimum of 1 year experience in negotiating with outpatient facilities and provider reimbursement rates.

·         Familiarity with CPT Coding, Medicare RBRBS and ASC Groupers.

·         Understanding of medical terminology.

·         Excellent communication skills.

·         Excellent organizational skills.

·         Professional appearance.

Physical Requirements

Requires sight and mobility to effectively operate various office machinery including but not limited to computers, telephone, copier, etc.  Must also be able to stand or sit for long periods throughout the day.  Computer/keyboard activity averages over 2/3 of time each day.  Sight requirements include close (clear vision at 20 inches or less), distance (clear vision at 20 feet or more), and ability to adjust the eyes to bring an object into sharp focus.  These requirements result from the demands of reading reports, information and working with computers.  Talking/hearing activity averages over 2.3 of time each day.

Telecommute

            No

Key Responsibilities:

• Serve as the first point of contact for employee inquiries and provide guidance on HR policies and procedures.
• Coordinate onboarding and offboarding processes, including new hire orientation and exit interviews.
• Maintain accurate and up-to-date employee records and ensure data integrity in the HRIS.
• Administer employee benefits, assist with open enrollment, and address benefits-related questions.
• Support employee relations by addressing concerns, conducting investigations, and documenting outcomes.
• Ensure compliance with federal, state, and local employment laws and regulations.
• Assist with payroll processing and timekeeping system maintenance.
• Support the performance management process, including reviews and employee development plans.
• Participate in recruiting efforts, including job postings, resume screening, and interview coordination.
• Assist in the development and implementation of HR initiatives, policies, and programs.
• Help plan and coordinate employee engagement and recognition activities.

Qualifications:

• Bachelor’s degree in human resources, Business Administration, or a related field.
• 2 -3 years of experience in a Human Resources Generalist or similar role.
• Strong knowledge of employment laws and HR best practices.
• Proficiency in HRIS systems and Microsoft Office Suite.
• Excellent communication, interpersonal, and organizational skills.
• Ability to handle sensitive information with a high level of confidentiality.

Job Summary:

The Receptionist serves as the first point of contact for clients, visitors, and employees, providing professional and friendly service. This role is responsible for managing the front desk, handling administrative duties assigned by manager.

Key Responsibilities:

• Greet and welcome visitors with a positive and professional demeanor.
• Answer and direct phone calls promptly and professionally.
• Manage incoming and outgoing mail, packages, and deliveries get to the office manager.
• Maintain office security by following procedures and controlling access (monitoring visitor log, issuing visitor badges, etc.).
• Schedule appointments, meetings, and conference room bookings.
• Assist with administrative tasks, such as data entry, filing, and documents preparation.
• Keep the reception area and common areas clean and organized.
• Complete assignments given by manager
• Handle inquiries and provide accurate information regarding the company, services, and policies.
• Order and manage office supplies inventory.

Qualifications & Skills:

• High school diploma or equivalent (Associate’s degree preferred).
• Proven experience as a receptionist, front desk representative, or similar role in medical.
• Excellent verbal and written communication skills.
• Strong organizational and multitasking abilities.
• Proficiency in Microsoft Office Suite (Word, Excel, Outlook) and office equipment (printers, copiers, etc.).
• Professional appearance and attitude.
• Ability to work independently and as part of a team.
• Strong attention to detail and problem-solving skills.
• Customer service-oriented mindset.

Work Environment & Schedule:

• This position operates in a professional office setting.
• Standard work hours are 37.5 with occasional flexibility based on business needs.

Compensation & Benefits:

• Competitive salary based on experience.
• Health, dental, and vision insurance (if applicable).
• Paid time off and holidays.
• 401(k) plan with company match (if applicable).
• Opportunities for career growth and professional development.

Supervisor

            Controller

Job Classification

            Administrative

            Non-Exempt

Job Summary

Cash Management

Manage bank records and processes, i.e. deposit verification, online banking systems, maintain bank statements, analyze bank fees, and implement banking-related changes as needed.

Accounts Receivable

Reconciliation of payments and customer accounts. Communicate discrepancies to management team, identify slow-paying customers, and recommend collection candidates.

Job Responsibilities

            Cash Management Responsibilities

·         Prepare and monitor online transfers by verifying documentation, and preparing disbursements.

·         Ensure all activities are in compliance with fraud prevention measures, accounting guidelines, company policies, and internal controls.

·         Review and reconcile the bank accounts.

Accounts Receivable

·         Gather and verify invoices for appropriate documentation prior to payment.

·         Maintain accounts receivable records to ensure aging is up to date, credits, and collections are applied, uncollectible amounts are accounted for, and miscellaneous differences are cleared.

·         Perform daily cash management duties, including distribution of cash receipt logs, and posting of cash to the accounts receivable sub-ledger.

Accounts Payable

·         Process company credit card charges and reconcile charges to the statement.

·         Manage charges for corporate account (Costco, Sams’ Club, etc.)

·         Maintain vendor accounts in accounting software.

·         Process annual 1099’s.

·         Assist with providing documentation for annual audits.

·         Reconcile AP sub-ledger to the General Ledger.

Qualifications

·         Understanding of general ledger journal entries, P&L, balance sheet reconciliation and reporting.

·         Understanding of accounting principles.

·         Exceptional time management, communication, and problem-solving skills.

·         Strong Math and research skills.

·         Organized and detail oriented.

·         Ability to analyze and interpret data and solve practical problems.

·         Understanding of Multi-entity sub ledger reporting and reconciliation of inventory, A/P, and A/R.

·         Understanding of fixed asset documentation.

·         Must be able to maintain a professional demeanor in all situations and work effectively both individually and with a team.

Physical Requirements

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

While performing the duties of this job, the employee is regularly required to talk and/or listen/hear. Specific vision abilities required by this job include close vision and ability to adjust focus. This would require the ability to lift files, open filing cabinets and bend or stand on a stool as necessary.

The following job description is a general outline of essential and common functions related to the performance of your job.  All employees of USA Quality Staffing are expected as a condition of employment to perform tasks as assigned by management whether included in your job description or not.

Supervisor

          VP of Repricing

Job Classification

          Office/Clerical

          Non-exempt

Job Summary

To process hospital and physician medical claims in an accurate and timely time frame.

Job Responsibilities

·       Accurately reprice all medical claims (both Physical & EDI0.

·       Read UB_92 and HCFA form to complete the repricing process.

·       Verify the accuracy of al OPEN and REJECTED control numbers.

·       Identify and document any and all errors identified in the OCR process or processing.

·       Verify provider system information to ensure proper quality control measures are taken.

·       Forward all provider discrepancies to Quality Control for verification.

·       Reprice and return all claims to client within contractual requirements.

·       Cross train in other departments as requested by management.

·       Reprice all medical claims to consistently meet production and accuracy quotas.

• Adhere to USA Managed Care Organization’s Information Security Policies and Procedures
• Adhere to HIPAA Guidelines and Requirements

Qualifications

·       Must be able to reprice a minimum of 250 claims per day with an accuracy rate of no less than 98% by the end of first 90 days of employment.

·       High school graduate or equivalent.

·       ICD9 and CPT4 coding, medical terminology with a minimum of 2 years prior claims processing experience.

·       Familiarity with AS400 and PPO’s a plus.

·       Must be detail oriented.

Physical Requirements

Requires sight and mobility to effectively operate various office machinery including but not limited to computers, telephone, copier, etc.  Must also be able to stand or sit for long periods throughout the day.  Computer/keyboard activity averages over 2/3 of time each day.  Sight requirements include close (clear vision at 20 inches or less), distance (clear vision at 20 feet or more), and ability to adjust the eyes to bring an object into sharp focus.  These requirements result from the demands of reading reports, information and working with computers.  Talking/hearing activity averages over 2.3 of time each day.

Telecommute

          No