Medical Collections Specialist - Hybrid Job at Florida Pediatric Associates, LLC
Florida Pediatric Associates, LLC Saint Petersburg, FL 33704
Medical Collections Specialist
Florida Pediatric Associates is seeking an experienced Medical Claims/Billing Specialist to join the team.
Hybrid position 1 day a week from the office and 4 days a week at Home
Top benefits package includes:
- 100% Employer Paid Employee Medical
- Dental
- Vision
- 100% Employer Paid STD & LTD
- Supplemental Insurance Options
- 15 Days PTO – First Year
- 7 Paid Holidays
- 401k Plan and Amazing Work Environment
Qualifications:
Education:
- High School Diploma or GED
- Certification in medical coding (CPC) preferred
- Working knowledge of Medicare and Florida Medicaid coding rules and regulations including but not limited to as National Correct Coding Initiative edits and payer guidelines.
- Working knowledge of the current International Classification of Diseases (ICD), Current Procedural Technology (CPT) and Healthcare Common Procedure Coding System (HCPCS) coding and terminology.
Experience:
- Two or more years of medical claims collections/accounts receivable management experience including patient (self-pay), commercial and government payer classes.
- Two of more years of medical coding and/or healthcare billing experience.
- ICD, CPT and HCPCS coding experience
- Experience with any of the following: Athena (IDX Group Management, ECW, APRMA, Medflow, Medicare, PMD.
Principal Duties and Responsibilities:
Specific:
Specific:
- Review and analyze third party payer accounts receivable and execute necessary collection actions and follow-up as prescribed by Department Policies, Procedures and Protocols.
- File claim appeals for denied and rejected claims per payer guidelines, including but not limited, to payer-imposed deadlines.
- Verify patient insurance eligibility.
- Verify patient account balances.
- Verify insurance company refund requests.
- Research and respond to payer questions and requests for information as prescribed by Department Policies, Procedures and Protocols.
- Research and respond to Practice staff, Client and patient questions pertaining to outstanding balances.
- Review ICD diagnosis with CPT codes to ensure compatibility.
- Review CPT code with Site of Service to ensure compatibility.
- Reconcile Client practice charges to Client appointment schedule, rounding list, charge capture system and other sources to ensure all patient charges are captured.
- Verify patient eligibility when needed.
- Enter patient demographic information when needed.
- Accurately post manual and/or electronic charges into the Practice Management Billing System in a timely fashion to meet or exceed Department performance standards.
- Understand the proper use of modifiers and assign appropriate modifier where indicated.
- Ensure the timely and accurate collections of accounts receivable for assigned payers.
- Maintain payer aged accounts receivable greater than 120 days within the benchmark defined by Department Policies and Procedures.
General:
- Serve as brand representative for FPA by embracing the Company culture and mission statement, core values and standards of conduct.
- Strictly adhere to all Standards.
- Compliance Standards.
- Privacy and Security Standards.
- Workplace Standards.
- Workforce Standards.
- Strictly adhere to Department policies and procedures.
- Participate in quality assurance and quality improvement process.
- Participate in corporate compliance program.
- Promptly report suspected acts of non-compliance with Company Standards and Policies.
- Participate in job-related continuing education programs.
- Perform other duties as assigned by your supervisor or designee.
EEOC Disclaimer:
FPA provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression. In addition to federal law requirements, FPA complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
FPA provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression. In addition to federal law requirements, FPA complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training.
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