Job Summary :
Performs collection functions for First Physician Group. Reviews charges and verifies appropriate usage of modifiers, CPT-4, ICD-9 and ICD-10 code ensure appropriate reimbursement.
Analyzes and corrects claims to ensure accurate and timely claims submission. Sets up account for Client Services and collects past due balances.
Responsible for resubmission of claims for additional reimbursement and / or appealing said claims with timely follow up.
Responsible for calculating and posting contractual allowances accurately and timely keeping the AR to a minimum. Responsible for incoming and outgoing mail.
Researches and answers customer’s questions regarding billing disputes. Interacts with FPG Physicians, Office Managers, CBO staff, and other appropriate SMH staff to review coding and billing issues.
Responsible for keeping abreast of and complying with all third party regulations. Responsible for ensuring all fee schedules are kept current and MMS updated.
Handles all correspondence and all communications in a timely manner. Job knowledge is section specific. Ability to demonstrate Customer Service Recovery, be flexible and adapt to changes in growth within the CBO Department.
Required Qualifications :
- Require an Associate’s Degree. A high school diploma, plus two (2) years of relevant Patient Financial Services or related experience, may be substituted for required degree.
- Require the ability to manage special projects and task to completion.
- Require the ability to be cross-trained in two (2) or more specialty areas.
- Require general knowledge of ICD-9, ICD-10 and CPT coding.
- Require the ability to analyze problems, develop solutions and consistently follows through to resolution.
- Require the ability to meet and greet public and handle difficult situations diplomatically.
- Require a clear and distinct speaking voice.
- Require the ability to operate an adding machine quickly and accurately by touch.
- Require the ability to use standard office equipment.
- Require basic mathematical, organizational, and communication skills.
- Require basic knowledge of Managed Care remittance and adjustment process.
Preferred Qualifications :
- Prefer three (3) years of experience working with Medicare, Medicaid and commercial billing and collections.
- Prefer three (3) years of experience in utilizing Windows based software applications.
- Prefer the ability to type fifty (50) words per minute for CRT and PC input.
- Prefer financial or banking experience.
Mandatory Education :
Preferred Education :
Required License and Certs :
Preferred License and Certs :
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