Revenue Cycle Insurance Spec | Patient Billing Coordinator | Days | Full-Time

Overview Responsible for obtaining appropriate reimbursement for Accounts Receivables for professional services of patients seen in physician offices, outpatient hospital, inpatient hospital, ASC, urgent care, ER, off‑site hospitals and Telehealth locations while maintaining timely claims submissions. Responsibilities and Duties Registers patients and completes necessary documentation, including insurance verification and benefits determination. Research charges to submit to the appropriate carrier according to federal/managed care rules, regulations, and compliance guidelines. Review codes using CPT, ICD‑10, HCPCS, and CCI guidelines to ensure compliance with institutional policies for coding and claim submission. Enter and bill professional charges into the automated billing system program. Utilize resources and tools in the resolution of invoices following company policy for assigned payors. Resolve outstanding balances with internal and external communication with customers. Triage invoices and determine appropriate action, completing the process required to obtain reimbursement for all types of professional services by physicians and non‑physician providers, maintaining timely claims submissions and appeals processes as defined by individual payors. Resubmit insurance claims when necessary to the appropriate carrier based on each payor's specific process and timelines. Research, respond to, and take necessary action to resolve inquiries from PSRs, the Cash Department, Charge Review, and Refund Department requests; follow up via professional emails to ensure timely resolution of issues. Communicate with payors regarding procedure and diagnosis relationships, billing rules, payment variances, and assertively and professionally set expectations for review or change. Review, research, and facilitate corrections of insurance denials, charge posting, and payment posting errors. Follow all managed care guidelines using the UFJPI Payor Claims Matrix and Managed Care Matrix for each contracted plan. Identify and enter affected invoices on the MES (Monthly Escalation Spreadsheet) using Excel, ESM, or other spreadsheets as needed. Inform the Team Leader on the status of work and unresolved issues, and alert to backlogs or issues requiring immediate attention. Identify trended denials and report to supervisor. Qualifications High School Diploma or GED equivalent – required. Associate degree – preferred. Certificate – Medical Terminology – preferred. Experience with EPIC System – preferred. 3 years healthcare experience in medical billing – preferred. Experience with online payor tools – preferred. Additional Duties Additional duties as assigned may vary. UFJPI IS AN EQUAL OPPORTUNITY EMPLOYER AND DRUG‑FREE WORKPLACE #J-18808-Ljbffr University of Florida Jacksonville Physicians, Inc.