Medical Billing & Collections Specialist (ASC/ Surgical- Remote Charlotte Area) 2/2

Full-time position, benefits eligible, 40 hours per week. Schedule: Monday–Friday, 40 hours (6:00 AM–6:00 PM, variable).

Pay

$21.85 – $32.80 per hour.

Responsibilities

• Review medical records for documentation accuracy and assign the correct CPT and ICD-10 codes to the claim.
• Conduct or assign audit reviews of coding and procedure specifications.
• Perform and oversee all billing processes, including primary/secondary and rebilling, with necessary claim edits on both internal and external software systems.
• Remain knowledgeable and current on rules and regulations related to all government payers: Medicare, Medicaid, VA, etc.
• Check clearinghouse transmission daily to ensure files are successfully transmitted to the intermediary; work closely with vendors when problems or trends arise that impede workflow.
• Handle follow-up on billed patient accounts to successfully collect owed balances.
• Post payments via cash, credit cards, EFT, and third-party vendors.
• Review and adjudicate EOBs/RAs to determine if the Surgery Center was paid correctly by the payer.
• Deal with denials efficiently and effectively, handling appeals as needed to get claims paid.
• Remain actively involved in KPIs associated with the financial performance of the Surgery Center.
• Utilize management reports, work queues, spreadsheets, payer remits, and denials information to improve claims submittal processes and reduce financial losses.
• Determine best-case claim outcomes and escalate issues upstream to Administration to prevent recurrence of problems.
• Responsible for the daily billing, follow-up, and collection resolution of hospital and professional claims filed to various payors.

Requirements

• High school diploma required; Associate degree, suitable Trade School, or Coding Certification preferred.
• 2–5 years’ experience in a medical environment required, with strong medical terminology knowledge, preferably in the surgical realm.
• Thorough working knowledge of CPT and ICD-10 codes; ability to process outgoing claims, write billing edits, transmit transaction files, and process payments.
• Strong typing skills and significant computer experience, including email, copier, and Microsoft Office.
• EMR experience required (clerical and clinical functions).
• Knowledge of ASC billing preferred.
• Knowledge of billing rules and regulations through various governmental programs, commercial claim submission, and HIPAA guidelines.

Physical Requirements

• Ability to lift, carry, push, or pull up to 20 pounds and, occasionally, over 20 pounds.
• Standing and walking 30% of the time; sitting 70% of the time.
• Eye/hand coordination, finger dexterity, color perception, functional visual ability, depth perception, functional sound perception and discrimination, functional verbal speech ability.
• Occasional bending, kneeling, climbing, twisting, reaching at or above and below shoulder level.
• Routine balancing as it pertains to normal office environment duties.

Benefits

• Paid Time Off programs.
• Health and welfare benefits: medical, dental, vision, life, short- and long-term disability.
• Flexible Spending Accounts for eligible health care and dependent care expenses.
• Family benefits: adoption assistance and paid parental leave.
• Defined contribution retirement plans with employer match and other financial wellness programs.
• Educational Assistance Program.
• Base compensation within the listed pay range based on qualifications, skills, relevant experience, and/or training.
• Premium pay such as shift, on-call, and more based on the teammate's job.
• Incentive pay for select positions.
• Opportunity for annual increases based on performance.

About the Organization

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia, and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience, and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health serves nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics, and rehabilitation, as well as organ transplants, burn treatments, and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.