Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty medical practice with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. Wilmington Health is committed to using collaborative, evidence-based medicine in providing the highest quality of care to the patients we serve.
Purpose:
Ensures prompt collection of the appropriate amount due
Essential Duties/Responsibilities:
- Follow-up with carrier regarding outstanding claims as noted on the outstanding invoice report
- File claims that require additional documentation
- Verify benefits as requested by physician
- Change insurance information as appropriate
- Correspond to carrier for such things as appeals and or inquiries
- Communicate all insurance regulation changes to supervisor
- Contact patient and or carrier to follow-up on denials and termination of coverage
- Respond to telephone calls; review and respond to correspondence
- Process computer refunds due patients and insurance companies
- Establish payment plans
- Defines relationship issues and acts as advocate for referring providers and office staffs to cross-functionally resolve outstanding issues with WH and ensures that resolutions are satisfactory and referral process is satisfactory.
- Works collaboratively with occupational health and corporate wellness to establish integrated strategic business plans to achieve corporate objectives for products and services.
Other Duties:
- As assigned by manager
QUALIFICATIONS
Required:
- High school diploma or general education degree (GED)
- 3-5 years' experience in a medical office environment
- or equivalent combination of education and experience
Preferred:
- Experience in Medical Office Administration
- Knowledge of the OSHA and DOT regulations
- Experience with urine drug screen collection and breath alcohol tests processes
- BLS/CPR Certified
Wilmington Health is an Equal Opportunity Employer committed to providing equal opportunities to all applicants and employees. We are committed to treating everyone equally and with respect regardless of race, age, sex, religion, national origin, citizenship, marital status, veteran’s status, sexual preference, disability, genetic information, or any other class protected under state or federal law.
ADA Physical Demands:
Rarely (Less than .5 hrs/day) Occasionally (0.6 – 2.5 hrs/day) Frequently (2.6 – 5.5 hrs/day) Continuously (5.6 – 8.0 hrs/day)
Physical Demand
Required?
Frequency
Standing
Occasionally
Sitting
Continuously
Walking
Occasionally
Kneeling/Crouching
Rarely
Lifting
Rarely
Required:
2-3 years of experience in medical billing, specifically with claims denials, appeals, corrected claims. May have a remote option at a certain point.
Skills Required
- High school diploma or GED
- 3-5 years of experience in a medical office environment, or equivalent combination of education and experience
- 2-3 years of medical billing experience, specifically handling claims denials, appeals, and corrected claims
- Experience in medical office administration
- Knowledge of OSHA and DOT regulations
- Experience with urine drug screen collection and breath alcohol testing processes
- BLS/CPR certification
What We Do
Since 1971, Wilmington Health has been committed to the care and health of our community in Wilmington as well as all of Southeastern North Carolina. Wilmington Health is structured as a multi-specialty clinic with primary care providers integrated into the system. In this way, Wilmington Health is able to provide a comprehensive and coordinated approach to the care of all our patients. In 2013, Wilmington Health was named a 2013 Acclaim Award Honoree by the American Medical Group Association (AMGA). The prestigious honor is awarded annually to only three national healthcare organizations. Previous esteemed Acclaim Award Honorees include Mayo Clinic Health System, Johns Hopkins Medicine, and The Cleveland Clinic. Wilmington Health’s drive to become a High Performance Health System (HPHS) began over five years ago by taking a programmatic approach involving a three part system of change including direction setting by our leadership, process improvement at the ground level, and a redesign of the most elemental processes throughout the organization. A priority was given to paying careful attention to metrics, analysis, and critical assessment of each innovation and how these changes may affect the total cost of care. Only by understanding each of these aspects at work, was the organization able to pragmatically and intelligently design a future approach to the provision of healthcare. Additionally, Wilmington Health leadership began to put greater focus on creating a culture of change within the organization, understanding that this is the most powerful tool in any transformative process. Included were new and improved support systems for staff and providers and development of an inspirational approach to leading the entire team to provide patient-centered healthcare. July 2012, Wilmington Health partnered with Blue Cross and Blue Shield of North Carolina to form an ACO agreement. This was the first insurer-provider Accountable Care Organization in the region.
