Physician Billing Specialist-Full Time-Days

Facility

Cape Fear Valley Medical Center

Location : Fayetteville, North Carolina

Department : Physician Financial Services

Job Family : Clerical

Work Shift : Days (United States of America)

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

Major Job Functions

The following is a summary of the major essential functions of this job. The incumbent may perform other duties, both major and minor, that are not mentioned below. In addition, specific functions may change from time to time :

• 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 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 (i.e 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
• Keeps management team abreast of challenges with reimbursement or claim related trends
• Other duties as assigned

Minimum Qualifications

Education and Formal Training

Work Experience

Knowledge, Skills, and Abilities Required

Physical Requirements

Cape Fear Valley Health System is an Equal Opportunity Employer M / F / Disability / Veteran / Sexual Orientation / Gender Identity