Commercial Billing Specialist/Job ID:1577038

Florida Physician Group Inc

  • Hialeah, FL
  • Permanent
  • Full-time
  • 13 days ago
  • Apply easily
Florida Physician GroupFPG Corp OfficesJob SummaryUnder the direction of the Directors or designee, the Billing Specialist ensures all Commercial / Managed Care, Medicare and Medicaid claims are reviewed for claim edits, claim submission, and timely follow up, as assigned.Duties and Responsibilities:
  • Review all Manager holds in Athena and resolve the challenges so that the claims are resubmitted clean and are paid in less than 35 days
  • Reporting to the Directors and Practice Managers any challenges with consistent issues with staff members quality of work and the need for training or corrective action steps
  • Monitor through Athena reporting and provider documentation split shared and incident 2 billing guidelines
  • Submit claims to carriers with the appropriate remarks and/or attachments during claims resolution
  • Run insurance eligibility and correct claim before submission, as needed
  • Pull supporting documents for annual regulatory audits, as needed
  • Ensure credit balances are reviewed and resolved timely
  • Assist in the charge posting and holds resolution process in all practices, when needed
  • Provide education to team when needed and necessary
  • Other billing assignments, within skillsets and abilities
  • Any other duties as assigned
  • Travel to Broward and Dade practices for training
EducationCertified coder Certificate or DegreeHigh School graduate or equivalentExperienceMinimum 2-years Commercial / Managed Care / Medicare / Medicaid billing experience in an acute Physician Practice setting billing for Medicare part B fee'sWorking knowledge of Common Procedural Terminology (CPT), HCPCS and ICD10 CodeWorking knowledge of Federal, State, and Commercial billing guidelinesLanguage: Bilingual English/Spanish is preferred

Florida Physician Group Inc