Medical Billing Rep

A large healthcare organization is looking to fill a 5 month CONTRACT HYBRID position in the Tampa, Florida area.

We are seeking a detail-oriented Billing Representative to join our team. The ideal candidate will have experience with CPC Certification, CPT/ICD 10 coding experience. This position offers an opportunity to work in a dynamic environment where accuracy and efficiency are key.

OVERVIEW OF POSITION:

The Billing Rep reports to the Billing Manager and is responsible for performing medical billing functions and providing administrative support to the Billing and Collections department. Positions in this function interact with customers and ancillary departments gathering support data to ensure invoice accuracy and work through specific billing discrepancies. Manage the preparation of invoices and complete reconciliation of billing with accounts receivable. May also include quality assurance and audit of billing activities.

Requirements needed for resume submittal:

EDUCATION:

• High school diploma, G.E.D. or equivalent
• Some college education preferred.

EXPERIENCE:

Minimum:

• CMC, CPC-A Certification
• Over 1 year of related job experience.
• CPT/ICD 10 codes experience.

Preferred:

• CPC Certification
• Previous coding experience.
• HMO/managed care, Medicare experience.
• Previous Allscripts, eCW, Athena, and/or RCX system experience.
• PCP and Hospitalist billing and coding experience.

KNOWLEDGE, SKILLS, ABILITIES:

• Computer literate.
• Microsoft Office skills
• Working knowledge of business billing office duties.
• Working knowledge of Medicare, Medicaid, and Managed care.
• Good verbal and written communication skills.
• Organized and detail oriented.
• Ability to work under time constraints.
• Bilingual preferred.

ESSENTIAL FUNCTIONS OF THE POSITION:

• Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with every internal and external customer.
• Represents the Company in a professional manner, following all Company policies and procedures.
• Uses, protects, and discloses patients' protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
• Ability to establish and maintain effective and positive working relationships with staff and management.
• Ensures the timely submission of primary and secondary claims.
• Maintains current working knowledge of CPT and ICD 10 codes, required modifiers and encounter data.
• Performs electronic claims submission.
• Notifies management of issues arising from erroneous codes, missing information, and error/edit messages.
• Analyze relevant information to determine potential reasons for billing discrepancies and changes.
• Seek assistance from internal partners (e.g., Coding; Credentialing; Clinics; Contracting) and/or external stakeholders (e.g., individual customers/payers; brokers) to resolve billing issues.
• Reviews insurance claim forms for accuracy and completeness. Makes necessary corrections.
• Demonstrates and applies knowledge of Medicare and Medicaid guidelines in reviewing claims to ensure appropriate use of modifiers and CPT/ICD 10 codes.
• Review medical documentation to confirm appropriateness of codes when necessary.
• Corrects claims appearing on Edit Reports.
• Communicates system and claim formatting issues to the IT department and Billing Manager.
• Serves as a resource to the staff on general billing guidelines.
• Demonstrate understanding of business partners' operations to identify appropriate resources for support and information.
• Perform quality checks on data entries prior to submitting information to internal and/or external customers/payers/clients.
• Inform customers/payers of billing problem/issue findings and resolution as appropriate.
• Contact external customers/payers to keep them informed of outstanding balances and required payment, as appropriate.
• Demonstrate and maintain understanding of state and federal regulatory requirements as they apply to billing operations (e.g., health-care reform; state surcharges; CMS)
• May conduct training (e.g., on-line demonstration; knowledge base; invoice inquiry) to co-workers (e.g., new staff members, collection/cash posting teams) on how to access, review, and/or submit claims for payments.
• Must be dependable and well organized.
• Performs additional duties as assigned.

Join our team as a Billing Representative and contribute to our commitment to excellence in financial operations.

If you are interested in learning more about this opportunity, please let me know. Looking forward to hearing from you.