CBO Specialist II
About The Position
As the Central Business Office (CBO) Specialist II, you will facilitate accurate professional billing, posting and collection for ProMedica Physicians and other supported entities. You will be responsible for accurate and timely follow up on denied professional insurance claims and be responsible for identifying trends with payors and/or procedures that are resulting in inaccurate payments, denials, or coding, and escalating within the proper departments for resolution. You will be responsible for accurately appealing denials within appeal limits of each payor to ensure reimbursement as contracts allow. You will be responsible for monitoring changes in payment policies by payors to ensure we have accurate edits in place within the Practice Management system for clean claim submissions. In this role, you will perform a variety of registration, billing, follow-up and collection functions for all payors, including self-pay. The above summary is intended to describe the general nature and level of work performed in this role. It should not be considered exhaustive.
Requirements
- High school diploma or equivalent.
- Experience reading and interpreting payor Explanation of Benefits.
- Experience navigating insurance payor websites for information, including, eligibility, claim status, and payment information.
- Experience with insurance appeals and interpreting insurance payment policy.
- Three (3) to five (5) years insurance follow up experience in a physician practice or physician billing setting.
Responsibilities
- Facilitate accurate professional billing, posting and collection for ProMedica Physicians and other supported entities.
- Perform accurate and timely follow up on denied professional insurance claims.
- Identify trends with payors and/or procedures that are resulting in inaccurate payments, denials, or coding, and escalate within the proper departments for resolution.
- Accurately appeal denials within appeal limits of each payor to ensure reimbursement as contracts allow.
- Monitor changes in payment policies by payors to ensure accurate edits are in place within the Practice Management system for clean claim submissions.
- Perform a variety of registration, billing, follow-up and collection functions for all payors, including self-pay.
Benefits
- Medical
- Dental
- Vision
- Company paid life insurance
- Paid time off
- 401k retirement plan
- Employee assistance program
- Other voluntary coverage options
- Employee discounts
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
