Commercial Billing Specialist / Job ID : 1603572

Job Description

Job Description

Florida Physician Group

FPG Corp Offices

Job Summary

Under the direction of the Directors or designee, the Billing Specialist ensures all Commercial / Managed Care, Medicare and Medicaid claims are reviewed for claim edits, claim submission, and timely follow up, as assigned.

Duties and Responsibilities :

• Review all Manager holds in Athena and resolve the challenges so that the claims are resubmitted clean and are paid in less than 35 days
• Reporting to the Directors and Practice Managers any challenges with consistent issues with staff members quality of work and the need for training or corrective action steps
• Monitor through Athena reporting and provider documentation split shared and incident 2 billing guidelines
• Submit claims to carriers with the appropriate remarks and / or attachments during claims resolution
• Run insurance eligibility and correct claim before submission, as needed
• Pull supporting documents for annual regulatory audits, as needed
• Ensure credit balances are reviewed and resolved timely
• Assist in the charge posting and holds resolution process in all practices, when needed
• Provide education to team when needed and necessary
• Other billing assignments, within skillsets and abilities
• Any other duties as assigned
• Travel to Broward and Dade practices for training

Education

Certified coder Certificate or Degree

High School graduate or equivalent

Experience

Minimum 2-years Commercial / Managed Care / Medicare / Medicaid billing experience in an acute Physician Practice setting billing for Medicare part B fee's

Working knowledge of Common Procedural Terminology (CPT), HCPCS and ICD10 Code

Working knowledge of Federal, State, and Commercial billing guidelines

Language : Bilingual English / Spanish is preferred

Must be able to pass Background and Drug Test screenings.