(This is a full time position that will support our RCM team at SouthPark Monday to Friday, 8 am to 5 pm)
Primary Job Responsibilities:
- Performs daily billing activities to ensure successful processing and payment of claims.
- Ensures claim information is complete and accurate for charge entry and data enters key demographic information necessary for insurance claim processing.
- Verifies all patient benefits, eligibility, and coverage to ensure accurate billing.
- Audits completeness and accuracy of all claims prior to submission to claims clearinghouse.
- Make necessary claim corrections to resolve payer claim edits and rejections.
- Reports billing changes, billing issues, and process improvement plan accomplishments to RCM Leadership.
- Completes tasks in RCM to resolve patient cases (via phone or written communication), process virtual payments, process insurance refund requests, research missing payments, process bankruptcy and deceased patient notifications, and collection account reconciliation.
- Ensures compliance with all Health Insurance Portability and Accountability Act (HIPAA) standards.
- Performs other duties as required or assigned within the scope of responsibility.
- Minimum of two (2) years of complex claim follow-up experience in a physician office, hospital, ambulatory surgery center or centralized medical business office.
- Knowledge of medical terminology, ICD-10, and CPT codes.
- Excellent computer skills; Intermediate skill with Microsoft Word, Outlook, and Excel.
- Experience working within EMR systems. Experience with AthenaHealth EMR is a plus.
- Experience interpreting payor explanation of benefits.
- Excellent verbal communication skills and strong customer-service background.
- Ability to manage time and organize daily schedule to meet productivity and accuracy standards.
Education and Certifications:
- High school diploma or equivalent required.
- Associate degree in business, healthcare administration or related field highly preferred.
Physical Requirements:
- Work consistently requires walking, standing, sitting, lifting, reaching, stooping, bending, pushing, and pulling.
- Must be able to lift and support weight of 35 pounds.
- Ability to concentrate on details.
- Use of computer for long periods of time.
Skills Required
- Minimum of two years of complex claim follow-up experience in a physician office, hospital, ambulatory surgery center, or centralized medical business office
- Knowledge of medical terminology, ICD-10, and CPT codes
- Excellent computer skills
- Intermediate proficiency with Microsoft Word, Outlook, and Excel
- Experience working within EMR systems
- Experience with AthenaHealth EMR
- Experience interpreting payer explanations of benefits
- Excellent verbal communication skills and strong customer-service background
- Ability to manage time and organize daily work to meet productivity and accuracy standards
- High school diploma or equivalent
- Associate degree in business, healthcare administration, or related field
- Ability to lift and support 35 pounds
What We Do
As an independent practice, the difference is personal. The physicians of Tryon Medical Partners joined forces because we share a core belief: the patient-doctor connection is the foundation for better health. This is the reason we are an independent practice. It allows us to remain true to our principles, while delivering better care rooted in stronger relationships. What are the benefits of choosing an independent practice? Value – We are able to practice medicine and conduct business nimbly and efficiently, with fewer layers of bureaucracy in our way – or our patients’. Transparency – As a leaner organization, we are in direct contact with our patients and partners. Keeping it personal means serving with integrity and accountability. Choice – In the changing world of healthcare, consolidation has become the new normal, and options are shrinking. We created an independent practice because we believe more choices should be available to everyone. Better health comes from having more than a healthcare provider. It takes a healthcare partner.
