Physician Billing Specialist-Full Time-Days

Location: Fayetteville, North Carolina – Department: Physician Financial Services – Work Shift: Days

About the role

Handle all aspects of Accounts Receivable for professional claims including denial management, analysis of denials, follow-up on unpaid claims, and identification of barriers to reimbursement.

Responsibilities

• 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 the 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 (e.g., 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.
• Keep the management team abreast of challenges with reimbursement or claim-related trends.
• Other duties as assigned.

Requirements

• High school graduate or equivalent required.
• 1-year experience in physician billing, medical practice charge entry or coding, and/or hospital revenue cycle process and practices required.

Skills

• Knowledge of medical billing and insurance reimbursement practices and procedures, and medical insurance requirements.
• Communication skills and 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 lightweight files.