Physician Billing Specialist-Full Time-Days

capefearvalley; United States; On-site; USD 42,000 - 60,000; Full time

Job summary

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

You will coordinate with practices and hospital departments, research issues, and correct problems to ensure accurate claim resolution and timely reimbursement, while delivering strong customer service.

Qualifications

• High school graduate or equivalent required.
• 1 year of physician billing or related revenue cycle experience required.
• Proficiency in reading, writing, and speaking English.
• Knowledge of medical billing and insurance reimbursement practices.
• Typing speed of 45 words per minute.
• Strong communication and customer service skills.
• Familiarity with ICD-9 and CPT-4 coding.

Responsibilities

• Follow up on outstanding AR by analyzing denials and unpaid claims with payers.
• Research issues contributing to unpaid claims and ensure timely payment.
• Coordinate with practices/hospital departments to answer claim questions.
• Process claims in revenue cycle system; check eligibility and corrections.
• Complete Payment Tracking and refund forms as needed.
• Notify management of reimbursement challenges and trends.
• Other duties as assigned.

Skills

English proficiency

Customer service

Communication skills

Teamwork

Typing 45 wpm

Microsoft Office

Medical terminology

ICD-9 CPT-4 coding

Education

High school diploma or equivalent

Tools

Microsoft Office

Job description

Facility

Cape Fear Valley Medical Center

Location

Fayetteville, North Carolina

Department

Physician Financial Services

Job Family

Clerical

Work Shift

Days (United States of America)

Summary

Handle 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 Functions

• 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 claims
• Ensure accurate claim processing by following up with payers as needed using payer websites and phone calls to ensure timely payment
• Work in revenue cycle system to process claims, check eligibility and make corrections to ensure customers and payers receive accurate and timely claim resolution
• Coordinate and communicate with practices/hospital departments as needed to answer claim related questions and process claims accordingly
• Research 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 hospital
• Complete refund forms for monies due to an insurance company or a patient due to an overpayment
• Keeps management team abreast of challenges with reimbursement or claim related trends
• Other duties as assigned

Minimum Qualifications

The 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 required

Work Experience

1-year experience in physician billing, medical practice charge entry or coding and/or hospital revenue cycle process and practices required

Knowledge, Skills, and Abilities Required

• Proficiency in reading, writing, and speaking the English language
• Knowledge of medical billing and insurance reimbursement practices and procedures and medical insurance requirements
• Communication skills
• Excellent customer service and teamwork
• Computer skills including Microsoft suite
• Knowledge of medical terminology, ICD-9 and CPT-4 coding
• Ability to type accurately 45 words per minute

Physical Requirements

• Motor coordination and finger dexterity required to operate the calculator, computer keyboard and typewriter
• Light lifting and carrying may be required
• Reaching for and handling light weight files

Required Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity