About this Physician Billing Specialist-Full Time-Days role at Cape Fear Valley Health
Facility
Cape Fear Valley Medical CenterLocation
Fayetteville, North CarolinaDepartment
Physician Financial ServicesJob Family
ClericalWork 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
The 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 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
