Billing/Collections Specialist

Healthcare Outcomes Performance Company•Royal Palm Beach, FL

17h

About The Position

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise. Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy. As Center for Bone & Joint Surgery of the palm Beaches continues to grow, we are looking for a Billing/Collections Specialist . Please see below for the functions and requirements for this position. ESSENTIAL FUNCTIONS Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards. Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers. Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections. Updates and confirms as necessary to allow processing of claims to insurance plans. Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients. Attaches referrals/authorizations to appointments/charges if available. Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals. Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines. Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement. Identifies and communicates trends and/or potential issues to management team. Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office. Other duties as assigned by leadership. Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections. Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans. Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement. Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients. Obtains and attaches referrals/authorizations to appointments/charges. Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards. Assumes full responsibility of reducing the accounts receivable of insurance balances by working through outstanding accounts. Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff. Identifies and communicates trends and/or potential issues to management team. Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle. At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following: Competitive Health & Welfare Benefits Monthly $43 stipend to use toward ancillary benefits HSA with qualifying HDHP plans with company match 401k plan with company match Employee Assistance Program that is available 24/7 to provide support Paid Time Off Paid Holidays Mileage reimbursement and more... #CBJ

Responsibilities

Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.
Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.
Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
Updates and confirms as necessary to allow processing of claims to insurance plans.
Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
Attaches referrals/authorizations to appointments/charges if available.
Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.
Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.
Identifies and communicates trends and/or potential issues to management team.
Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.
Other duties as assigned by leadership.
Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement.
Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
Obtains and attaches referrals/authorizations to appointments/charges.
Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.
Assumes full responsibility of reducing the accounts receivable of insurance balances by working through outstanding accounts.
Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.
Identifies and communicates trends and/or potential issues to management team.
Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.