Remote Complex Claims Billing and Patient Account Representative Details

Remote Complex Claims Billing and Patient Account Representative

Surgery Partners - Tampa, FL

Employment Type : Full-Time

We are growing… come grow with us!

Are you looking to join a company that values their employees and offers opportunities for career growth? Surgery Partners Shared Service Center is looking for motivated employees to join their team remotely! Competitive pay and full benefits offered, as well as comprehensive training to ensure success. Surgery Partners prides itself in promoting a culture of diversity and inclusion. Our Shared Service Center has a supportive management team committed to providing the tools needed for a successful team focused on collaboration, communication, and individual growth potential.

Surgery Partners owns and operates more than 180 locations in 32 states, including surgical facilities and ancillary services comprised of multi-specialty physician practices and anesthesia services. Apply now to explore joining our fast-paced and growing team!

GENERAL SUMMARY OF DUTIES:
Responsible for assisting with all functions associated with billing and third party payers. Must be an effective communicator who can express himself/herself on a daily basis in a professional manner both verbally and in writing as well as be a proactive professional who can identify collection trends and solve them in a timely manner.

EDUCATION:

• High School diploma.

• 5 years of experience with medical office billing procedures.

• Must have functional knowledge of medical terminology, anatomy, and physiology.

KNOWLEDGE:

• Knowledge of clinic policies and procedures.

• Knowledge of computer systems, programs and spreadsheet applications.

• Knowledge of medical terminology.

• Knowledge of collection practices.

• Knowledge of Medicare LCD as applied to specific claim requirements

• Knowledge of governmental, legal, and regulatory provisions related to collection activity.

ESSENTIAL FUNCTIONS:

• Identify cases where charges have been entered and successfully bill claims out including implants based on current contracts.

• Confirm claims have successfully cleared clearinghouse and has been sent to the payer

• Identifies delinquent accounts, aging period and payment sources, and performs collection actions including contacting patients by telephone and resubmitting claims to the appropriate payer.

• Evaluates patient financial status and establishes contract payment plans.

• Keeps informed on all current Medicare, Medicaid, and third party payer regulations and requirements. Informs management and other staff members of changes and keeps documentation current and accessible.

• Complete Appeals to payers as required based on payer requirements.

• Complete RAC audits for any Neuromodulation case requested.

• Successfully reduces days in A/R and meets assigned goals.

• Other assigned duties as required.

SKILLS:

• Skills in gathering and reporting claim information.

• Skills in solving utilization problems.

• Skills in written and verbal communication and customer relations.

• Skills in working with Windows based software systems

PERFORMANCE EXPECTATIONS:

• Ability to work effectively with medical staff and external agencies.

• Ability to identify, analyze, and solve claim problems.

• Well developed organizational and communication skills (both written and verbal).

• Highly professional, confident, conscientious, and cooperative attitude.

• Must be able to recognize and apply priorities, as well as exhibit attention to detail.

• Excellent communication skills with various internal and external customers.

PHYSICAL/MENTAL DEMANDS: Requires sitting and standing associated with a normal office environment.