Association Health Care Management

10/25/2022

to the winners of this year's Halloween Costume Contest: Stranger Things (The Billing Department). AHCM wishes to thank all the entrants in the 2022 AHCM Halloween Costume Contest. Everyone's costume looked great!

10/14/2022

There is no shame in having a sweet tooth today—it is National Dessert Day! National Dessert Day recognizes and celebrates desserts for their enormous contribution to making our lives even sweeter with their delicious taste. Whether you go out to your favorite bakery or whip up something delicious at home, share your celebrations with others.

10/13/2022

Company culture is important to employees because workers are more likely to enjoy work when their needs and values are consistent with their employers. If you work somewhere where the culture is a good fit, you'll tend to develop better relationships with coworkers and be more productive.

How important is company culture? When looking for a new job, employees value a business's culture more than salary, according to a new Glassdoor study.

10/11/2022

Are you looking for a change? A new career?

We invite you to join our job fair Today, 8am-3pm and Tomorrow October 12th; 8AM -12PM.

Location: 11111 Richmond Avenue #250 Houston, TX 77082

We are hiring Customer Service Representatives SAME DAY! $14- $15 Per Hour, Plus Benefits

10/10/2022

Good health encompasses not only physical well being but mental well being as well. This let's normalize prioritizing mental health, and asking for help. Spread awareness, reduce stigma.

10/09/2022

Join our job fair October 11th 8am-3pm & October 12th 8AM -12PM.

Hiring Customer Service Representatives SAME DAY! $14- $15ph plus incentives.

8 hour shifts 40 hours a week
Monday- Thursday:7am-7pm
Friday:7am-5pm
Saturday:8am-12pm
No cold calling/telemarketing.
Bring a printed copy of your resume
Dress for success!
Bi-lingual (Spanish) is a plus but not necessary.

Located in Westchase area - 11111 Richmond Avenue #250 Houston, TX 77082
Association Health Care Management is seeking Customer Service Reps to join our team in Houston, TX!
Our Company Profile:
AHCM is an organization with a passion for leadership, excellence, and innovation in the healthcare management.
We live and breathe our values in everything we do and every decision we make. As a member of AHCM's team, you are a part of an elite team designing the future. You will be expected to contribute your talents and energies to make what is already great about AHCM even better and available to more people. In return, we commit to working with you to make your career at AHCM rewarding.
The Role
A Member Services Representative addresses member inquiries, questions and concerns in all areas including enrollment, claims, benefit interpretation. Responsible for receiving, responding to, and directing member phone calls and written requests. Being a Member Services Representative provides available information upon request and research or escalates issues as appropriate. Maintains confidentiality per HIPAA guidelines. To be a Member Services Representative typically requires 1+ years of related experience.
Pay
Full Time Direct Hire - $14 - $15+/hour + Incentives
We Offer
• 401(k)
• 401(k) matching
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Paid training
• Vision insurance
• PTO
• Great Company Culture
• Bi-Weekly Incentives
• Career Mobility
Duties & Responsibilities
• Provide expertise or general customer service support by reviewing, researching, member inquiries.
• Consistently meet established productivity, schedule adherence and quality standards
• Answers phone calls regarding provider search, existing claims, and member IDs as needed.
• Adheres to privacy and confidential and proprietary company policies and procedures (i.e., HIPAA).
• Communications - interacts effectively
• Teamwork - Work and interact effectively as a team member; support the team approach
• You’ll need to be comfortable navigating across various computer systems to locate critical information. Attention to detail is critical to ensure accuracy and avoid financial loss to members and business.
Qualifications
• High school diploma or equivalent
• Excellent customer service skills or prior experience
• Demonstrated timely, consistent job attendance history
• Computer literate
• Ability to multi-task, this includes ability to understand multiple products and multiple levels of benefits within each product
• Strong attention to detail, time management, and decision-making skills
• Problem-solving skills
• Communicate professionally with positive demeanor
• Telephone skills
• Extended periods of sitting at a computer and use of hands/fingers across keyboard or mouse
• Pass background check
Job Type: Full-time
Pay: $14.00 - $15.00 per hour

10/05/2022

is the most common in U.S. women? American Cancer Society estimates 1 in 8 will be diagnosed in her lifetime. This , take time to learn about the risks, prevention and the importance of early detection:

Get detailed information about breast cancer risks, causes, symptoms, treatments, research, and more.

09/21/2022

What makes a company a great place to work?

Wondering what qualities make a great workplace? Learn about the most common qualities we see among our Top Workplaces winners & ways to meet this criteria.

09/14/2022

Mental health, along with physical health and social well-being, is an essential component of overall health.

09/06/2022

Position Title: Compliance Analyst



Position Location: Irving, TX

Minimum Scheduling Requirements: Monday-Friday 8am CT-5pm CT



Position Description: Compliance Analysts are responsible for investigating, managing, and responding to complaints, inquires and appeals. They are also responsible for reviewing data to detect risks and trends and for research and policy formation support.



Required Education: Bachelor’s degree (Political Science, International Affairs, Legal Studies, Business Administration, Health Administration)

Preferred Education: Master’s Degree (Political Science, International Affairs, Legal Studies, Business Administration, Health Administration), Certified in Risk and Information Systems Control (CRISC), Certified Regulatory Compliance Manager (CRCM), Certified Information Privacy Professional (CIPP)



Mandatory Performance Expectations:

1. Identify, review, understand and/or interpret industry standard medical bills including but not limited to ICD-9/ICD-10 codes, billing modifiers etc.

2. Conduct a preliminary review of medical records and understand basic information included but not limited to, patient’s medical history, treatment plans, reason for treatment etc.

3. Identify and review the applicable member guidelines and apply them to the facts presented in the appeal

4. Write response letters

Experience and ability to initiate, develop, maintain, and review policies and procedures for the operation of a healthcare compliance program and other similar activities to prevent unethical, illegal, or improper conduct

Healthcare compliance evaluation and auditing experience to be able to discover operational problems and recommend and execute strategies to provide needed solution

Strong ability to prioritize and perform multiple projects concurrently

Strong communication skills to effectively report project risks and progress to senior management and colleague

Strong knowledge of Excel, PowerPoint, and SAP

Proven ability to collaborate and advice management on compliance matters; ability to develop practical business solutions and to facilitate risk assessment

11. Investigate complaints and inquiries using plan/program guidelines; must be able to interpret and apply guidelines to fact patterns

12. Must be able to manage a desk of at least 40 or more complaints/case files at one time Navigate internal systems to retrieve critical information such as plan/program type, effective dates etc.

09/02/2022

Position Title: Compliance Coordinator



Position Location: Irving, TX

Minimum Scheduling Requirements: Monday-Thursday 8am CT-6pm CT and Fridays from 10am CT-2pm CT.



Position Description: The Coordinator serves as crucial, administrative support to the Compliance Team.



Education Requirements: HS diploma, Associates Degree (Political Science, International Affairs, Legal Studies, Business Administration, Health Administration)



Preferred Education: Bachelor’s degree (Political Science, International Affairs, Legal Studies, Business Administration, Health Administration)



Mandatory Performance Expectations:

1. Log incoming Compliance mail into the General Risk and Compliance (GRC) system, Issue Trak

a. This includes but is not limited to, complaints, appeals, inquires, reviews, etc.

2. Assign incoming correspondence to the correct analyst and/or stakeholders in Issuetrak

3. Maintain and manage deliverables reports and Issuetrak dashboards

4. Retrieve medical records and bills upon requests

5. Monitor, track and log web and social media activity (this includes but is not limited to Scampulse, Trust Pilot, Google, Yelp, etc.)

6. Mail, email and/or fax response letters upon request

7. Respond to telephonic inquires and requests in real time

8. Provide follow up phone calls and emails to members and/or requestors

9. Navigate the various internal systems to retrieve member information and to notate member accounts

10. Assist with research projects and compliance investigations

11. Provide additional ad hoc support to the compliance and executive teams

12. Able to interpret data and identify organization risks

Qualifications and Skills:

1. Must have good time management skills

2. Must be very organized

3. Must be reliable

4. Must have good communication skills

5. Must be collaborative and team oriented

6. Must be able to work independently (under micromanagement)

7. Must have experience with Microsoft Office (especially Word and Excel)

8. Must have a basic understanding of health insurance (basic understanding of Health Care Sharing Ministries is a plus)

9. Must understand how to read medical records and bills (UB04 forms, itemized statements)

10. Must be comfortable with public speaking

11. Must understand how to multi-task and prioritize urgent action items

12. Must be able to write coherent and clear responses via letter and/or email.

09/01/2022

Happy September! Let's be productive and make this month a September to remember.