Physician Billing Specialist-Full Time-Days

Cape-Fear-Valley-Medical-Center-; Fayetteville (NC); On-site; USD 40,000 - 60,000; Full time

Job summary

Cape Fear Valley Medical Center in Fayetteville, NC, seeks an Accounts Receivable Clerk to handle professional claims, denial management, and follow-up on unpaid claims within the Physician Financial Services department.

Responsibilities include analyzing denials, ensuring timely payment, and coordinating with departments to resolve claim issues. Requires 1 year of related experience and proficiency in MS Office and medical terminology.

Qualifications

• Proficiency in reading, writing, and speaking English.
• Experience in physician billing, medical practice charge entry or hospital revenue cycle.
• Ability to type accurately 45 words per minute.
• Knowledge of medical terminology and insurance reimbursement practices.

Responsibilities

• Follow up on outstanding A/R by analyzing denials and unpaid claims with payers.
• Research and resolve issues that delay reimbursement; use payer websites and calls as needed.
• Coordinate with practices/hospital departments to answer claim questions and process claims.
• Complete refunds and payment tracking forms when funds are received or returned.
• Identify barriers to reimbursement and communicate trends to management.

Skills

English proficiency

Customer service

Teamwork

Typing 45 wpm

Education

High school diploma

Tools

Microsoft Office

ICD-9 CPT-4 coding

Job description

FacilityCape Fear Valley Medical CenterLocationFayetteville, North CarolinaDepartmentPhysician Financial ServicesJob FamilyClericalWork ShiftDays (United States of America)SummaryHandle all aspects of Accounts Receivable for professional claims including denial management, analysis of denials, follow up on unpaid claims and identify barriers to reimbursement.Major Job FunctionsThe following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time:Follow up on outstanding A/R by working and analyzing denials, following up on unpaid claims (primary, secondary or tertiary) with payers and researching issues that have contributed to unpaid claimsEnsure accurate claim processing by following up with payers as needed using payer websites and phone calls to ensure timely paymentWork in revenue cycle system to process claims, check eligibility and make corrections to ensure customers and payers receive accurate and timely claim resolutionCoordinate and communicate with practices/hospital departments as needed to answer claim related questions and process claims accordinglyResearch and make necessary corrections to insurance company requests through timely follow-up and correspondence (i.e medical record requests, appeals, claims resubmissions)Complete Payment Tracking Forms when monies have been sent to the hospitalComplete refund forms for monies due to an insurance company or a patient due to an overpaymentKeeps management team abreast of challenges with reimbursement or claim related trendsOther duties as assignedMinimum QualificationsThe following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:Education and Formal Training:High school graduate or equivalent requiredWork Experience:1-year experience in physician billing, medical practice charge entry or coding and/or hospital revenue cycle process and practices requiredKnowledge, Skills, and Abilities Required:Proficiency in reading, writing, and speaking the English languageKnowledge of medical billing and insurance reimbursement practices and procedures and medical insurance requirementsCommunication skillsExcellent customer service and teamworkComputer skills including Microsoft suiteKnowledge of medical terminology, ICD-9 and CPT-4 codingAbility to type accurately 45 words per minutePhysical Requirements:Motor coordination and finger dexterity required to operate the calculator, computer keyboard and typewriterLight lifting and carrying may be requiredReaching for and handling light weight filesRequired Licenses and CertificationsCape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity