Billing/Collections Specialist

Job Description

Job Description

Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise.

Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy.

As Center for Bone & Joint Surgery of the palm Beaches continues to grow, we are looking for a Billing/Collections Specialist . Please see below for the functions and requirements for this position.

ESSENTIAL FUNCTIONS

• Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.
• Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.
• Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
• Updates and confirms as necessary to allow processing of claims to insurance plans.
• Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
• Attaches referrals/authorizations to appointments/charges if available.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.
• Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement.
• Identifies and communicates trends and/or potential issues to management team.
• Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.
• Other duties as assigned by leadership.
• Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to
  resolve any outstanding denials/rejections.
  • Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms
  as necessary to allow processing of claims to insurance plans.
  • Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims
  maximum reimbursement.
  • Researches all information needed to complete billing process including obtaining information from providers, ancillary
  services staff and patients.
  • Obtains and attaches referrals/authorizations to appointments/charges.
  • Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards.
  • Assumes full responsibility of reducing the accounts receivable of insurance balances by working through outstanding
  accounts.
  • Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff.
  • Identifies and communicates trends and/or potential issues to management team.
  • Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle.

At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following:

• Competitive Health & Welfare Benefits
• Monthly $43 stipend to use toward ancillary benefits
• HSA with qualifying HDHP plans with company match
• 401k plan with company match
• Employee Assistance Program that is available 24/7 to provide support
• Paid Time Off
• Paid Holidays
• Mileage reimbursement
• and more...

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