Job Description
Analyze claim denials and take corrective action including corrected claims submission, reconsiderations and appeals. Review and correct CPT codes, diagnosis codes, modifiers as needed. Apply accurate adjustments based on insurance guidelines and contracts. Manage secondary insurance and patient balances as needed. Work with billing team to identify denial trends and patterns and contribute to resolutions. Research, prepare and submit claim appeals for denied and underpaid claims.
Skills
Knowledge of medical terminology, CPT and ICD-10 codes; understanding of all aspects of the revenue cycle; ability to interpret payer EOBs and claim denials; how to make justified adjustments, post payments and resolve denied claims. Familiarity with patient portals and websites. Understanding of Florida Medicaid, HMO's, PPO's and Fee for Service payers; authorization and referrals. Previous physician office experience, especially patient check out, preferred if no prior billing experience. Previous orthopaedic office and/or billing experience a plus. CPC, CPMB or other billing certification required.
Pay
Based On Experience
Work Hours
M - F; 8:30 am - 5:00 pm