Physician Billing Specialist-Full Time-Days
Cape Fear Valley Health
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.
Job description
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
- 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
Requirements
- High school graduate or equivalent required
- 1-year experience in physician billing, medical practice charge entry or coding and/or hospital revenue cycle process and practices required
- Proficiency in reading, writing, and speaking the English language
- Knowledge of medical billing and insurance reimbursement practices and procedures and medical insurance requirements
- Communication skills
- Excellent customer service and teamwork
- Computer skills including Microsoft suite
- Knowledge of medical terminology, ICD-9 and CPT-4 coding
- Ability to type accurately 45 words per minute
Company overview
Cape Fear Valley Health is a comprehensive regional healthcare system based in Fayetteville, North Carolina, serving southeastern North Carolina and surrounding regions. Established in 1956, it has grown to become North Carolina's 8th largest health system, operating as a private not-for-profit organization with 7,500 employees and over 1,000 physicians. The system encompasses eight hospitals with 988 total beds, including Cape Fear Valley Medical Center, Highsmith-Rainey Specialty Hospital, Bladen County Hospital, Hoke Hospital, and Harnett Health facilities. Annually, the system serves more than 1 million inpatient and outpatient visits across its network of over 150 locations. Cape Fear Valley Health specializes in cardiac care, cancer treatment, surgical services, neuroscience, pediatrics, rehabilitation, orthopedics, and behavioral health. The organization has earned numerous national recognitions including Healthgrades Top 100 Hospital for Cardiac Care, IBM Watson Top 50 Cardiovascular Hospital, and The Leapfrog Group Grade-A for Patient Safety. With a mission to provide exceptional healthcare for all patients, the system emphasizes patient-centered care, innovation, and community service while maintaining multiple disease-specific certifications from The Joint Commission.