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SalaryAt FOI our goal is to provide our patients with world-class orthopedic care.
Our mission of providing the best care encompasses not only the care the physician provides, but all medical and administrative aspects of the patients encounter with Florida Orthopaedic Institute (FOI) as well. Every staff member plays a vital role in this mission. We take pride in receiving the Patriot Award from the Department of Defense for the support that we give to National Guard and Reserve members who are employed by FOI. We are committed to encouraging a culture of inclusion reflective of the communities we serve, and we provide equal opportunity to all. Florida Orthopaedic Institute conforms to the spirit as well as to the letter of all applicable laws and regulations.
What we offer:
- Full time opportunities available, with room for career growth and advancement.
- Excellent job security and stability, to promote an optimal work life balance.
- Be part of this dynamic and growing high level Revenue Cycle team!
In this role you will:
Under direct supervision of the Revenue Cycle Ancillary Supervisor, this position is responsible for assuring timely collection of accounts receivable, monitoring account activity and providing adequate follow up to ensure maximum reimbursement is received for Ancillary billing. The ideal candidate would have a strong understanding of medical claims billing.
- Research and resolve claims denials using the appropriate resources
- Check that pre-bill claims are passing internal edits in a timely fashion
- Monitor that all denied claims are corrected or appealed
- Collaborate with other teams within the business office
- Provide appropriate feedback to management.
Key Responsibilities:
- Performing collection activities, such as status calls to ensure timely reimbursement, appeals and account review.
- Ensuring appropriate information is submitted to insurance companies to expedite payment.
- Take appropriate follow up actions on accounts to ensure claims are paid on the first follow-up call or appeal.
- Determine that appropriate information is submitted to insurance companies to expedite payment.
- Following up on assigned cases from within the organization
- Reviewing pre-bill claim holds to verify that the claim goes out clean the first time
- Composing appeals to insurance carriers for denied claims
- Handle incoming calls for information request from insurance companies within 24 hours.
- Assisting Financial Counselors when patients have questions regarding claims
- Corrects accounts that are billed to incorrect insurance companies.
- Ensures authorizations are attached to claims
- Comply with quantity and quality expectations as provided by management
- Communicating with the lead, supervisor, and team to advise of trends, issues discovered
- Assure compliance with all company plans, policies and procedures set forth by the Florida Orthopaedic Institute
- All other duties as assigned.
About You
- High School Diploma or general education degree (GED)
- 2 4 years billing and denial management experience required
- Basic Understanding of ICD10, CPT/ HCPCS
- Ability to read and interpret explanation of benefits (EOBs)
- Knowledge of Medical Assistance, Medicare Part B and commercial insurance products
- Familiar with CMS 1500
- Basic understanding of medical terminology and anatomy.
- Excellent communication skills both written and verbal
- Must be a self-starter that is detail oriented and capable of multi-tasking
- Requires comprehensive knowledge of computer skills including Microsoft Office Suite
- Comfortable in a fast-paced working environment of a growing practice
We Would Love It If You Also Had:
- Athena EMR experience
- 1 year experience in Collections for a medical office environment, Physical/Occupation Therapy setting
- Experience with Durable Medical Equipment
