Charge/Follow-up Coordinator | Business Group Team 7 - ER | Days |Full-Time REMOTE

UF Health; Jacksonville (FL); Remote; USD 40,000 - 80,000; Full time

Job summary

An established industry player is seeking a detail-oriented medical billing specialist to join their team in a dynamic healthcare environment. This role is crucial for ensuring timely reimbursement for services provided, requiring expertise in coding, compliance, and effective communication with payers. The ideal candidate will thrive in a fast-paced setting, demonstrating strong problem-solving skills and a commitment to delivering exceptional service to patients and providers alike. If you are passionate about healthcare and ready to make a significant impact, this opportunity is perfect for you.

Qualifications

• 2+ years of healthcare experience in medical billing preferred.
• Familiarity with EPIC system and online payor tools is a plus.

Responsibilities

• Obtain reimbursement for professional services while maintaining timely claims submissions.
• Review and correct insurance denials and payment posting errors.
• Communicate effectively with payers and resolve outstanding claims.

Skills

Medical Billing

EPIC System

Insurance Verification

CPT/ICD10 Coding

Communication Skills

Problem-Solving

Education

High School Diploma or GED

Associates Degree

Certificate in Medical Terminology

Tools

Online Payor Tools

Automated Billing System

Job description

Overview

Summary:

Responsible for obtaining appropriate reimbursement for Accounts receivables for professional services of patients seen in all types of locations while maintaining timely claims submissions. Registers patients and completes necessary documentation including insurance verification and benefits determination. Research charges to submit to appropriate carrier according to Federal/Managed Care rules, regulations and compliance guidelines. Review codes using CPT, ICD10, HCPCS and CCI guidelines to ensure compliance with institutional compliance policies for coding and claim submission. Enter and bill professional' charges into automated billing system program. Utilize resources and tools in the resolution of invoices following company policy for assigned payor/s. Resolving outstanding balances with internal and external communication with customers.

Responsibilities

Competencies:

Hospitality:

• This domain incorporates the company value, "Caring."

• Employees are exhibiting hospitality when they are acting as hosts and are creating a welcoming, warm, and safe environment for patients, visitors, customers, and co- workers.

• Standards of Behavior in this domain include: First Impressions, Etiquette in Shared Spaces, Way-Finding, Patient & Customer Interaction, AIDET Communication, Patient Wait Times, Noise Levels, Patient & Visitor Problem-Solving.

Communication:

• Recognizes the need to make the exchange of critical information in a warm, welcoming and attentive manner. Make a personal connection that leads to excellent patient care and a positive experience for all customers.

• Practices all applicable items on the Hospitality Checklist at https://bridge.ufhealthorg/hospitality/resources/

• Achieves: Respects the patient's rights to privacy and confidentiality. Does not discuss patient care/employee information in public areas; maintains patient/employee information in a secure location. Actively listens to customers; insures customers understand both verbal and written communication. Uses appropriate body language and is hospitable in both oral and written communication.

• Exceeds: Is a role model in exhibiting all aspects of the communication standards on the hospitality checklist. The employee is acknowledged frequently for observable actions in his/her communications to customers. Maintains composure and provides compassion and empathy even when faced with hostility from others and/or other stressful conditions and anticipates customers' need for follow-up communication.

Teamwork:

• Works cooperatively with co-workers, volunteers, medical staff and other team members to achieve goals.

• Practices all applicable items on the Hospitality Checklist at https://bridge.ufhealth.org/hospitality/resources/

• Achieves: Helps and supports others in their efforts to solve customer problems and accomplish UF Health's goals, including patient/customer transition to next point of contact; listens to the concerns of the team, and communicates appropriately; shares information and own expertise with others to help others accomplish group goals; gives credit and recognition to others who have contributed to the team; supports and acts in accordance with final group decisions even when such decisions may not entirely reflect one's own position. Maintains respectful interactions with team members and treats colleagues with courtesy and respect. Recognizes coworker's accomplishments and acknowledges their successes on behalf of the team. Manage-up co-workers' contributions to the team.

• Exceeds: Helps to keep levels of team performance and morale high even during periods of intense pressure and high work volume; looks for alternative ways to work with others that will create better results and working relationships; solicits a diversity of perspectives on issues and uses ideas contributed by team members to shape decisions; breaks down barriers or organizational boundaries to ensure team's success. Is seen by co-workers as a role model in improving the appearance of the immediate work site as well as improving the appearance of the facilities outside of the immediate work site.

Professionalism/Responsibility:

• This domain incorporates the company values, "Integrity," "Quality," and "Accountability."

• Employees are exhibiting professionalism and responsibility when they act as ambassadors of UF Health and ensure that their integrity, appearance, work environment, and quality of work improve patient and customer perceptions, and UF Health's reputation.

• Standards of Behavior in this domain include Personal Responsibility, Physical Appearance & Presentation, and Appearance & Maintenance of Work Areas.

Responsibilities:

• Determine appropriate action and complete action required to obtain reimbursement for all types of professional services by physicians and non-physician providers maintaining timely claims submissions and timely Appeals process as defined by individual payors.

• Review and facilitate the correction of insurance denials, charge posting and payment posting errors.

• Complete correspondence inquiries from payors, patients and/or clinics to provide the needed information for claims resolution.

• Respond and send emails to all levels of management in the Business Groups, Cash Posting Department, Refunds Department, Managed Care, Clinics or CDQ to resolve coding and billing issues. Send follow up emails to ensure all necessary action is taken.

• Make outbound calls, written or electronic communications, web portals and or websites to insurance companies for status and resolution of outstanding claims.

• Review and interpret electronic remits and EOB's to work insurance denials and to determine appropriate insurance adjustments and obtain adjustment approvals as outlined in the company policy.

• Verify and/or assign key data elements for charge entry such as, location codes, provider #'s, authorization #'s, referring physician and etc.

• Re-file insurance claims when necessary to the appropriate carrier based on each payors specific appeals process with the knowledge of timelines.

• Research, respond and take necessary action to resolve inquiries from PSRs, Charge Review and Refund Department requests. Follow-up via professional emails to ensure timely resolution of issues.

• Must be comfortable speaking with payers regarding procedure and diagnosis relationships, billing rules, payment variances and have the ability to assertively set the expectation for review or change.

Qualifications

Qualifications:

• Experience Requirements:
• 2 years - Health care experience in medical billing - preferred
• 2 years -EPIC system experience - preferred
• 2- years -Experience with online payor tools - preferred

• Education:
• High School Diploma or GED equivalent - required
• Associates Degree - preferred
• Certificate Medical Terminology -preferred

• Additional Duties:
• Additional duties as assigned may vary.

UFJPI is an Equal Opportunity Employer and a Drug-Free Workplace.