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Billing Specialist

Family Health Centers of SouthWest Florida

Fort Myers, FL

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JOB DETAILS
SKILLS
Ambulatory Care, Analysis Skills, Billing, Co-Payments, Communication Skills, Current Procedural Terminology (CPT), Data Entry, Detail Oriented, Documentation, Fee Schedule, HIPAA (Health Insurance Portability and Accountability Act), Health Plan, Healthcare Common Procedure Coding System (HCPCS), High School Diploma, ICD-10, Insurance, Insurance Claims, Interpersonal Skills, Managed Care, Medicaid, Medical Billing, Medical Coding, Medical Record System, Medical Records, Medical Terminology, Medicare, Microsoft Excel, Microsoft Office, Multitasking, Patient Care Denials, Presentation/Verbal Skills, Problem Solving Skills, Time Management, Writing Skills
LOCATION
Fort Myers, FL
POSTED
5 days ago

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Job Type

Full-time

Description

POSITION DESCRIPTION:

The Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. The individual prepares and submits clean claims to Medicare, Medicaid, Commercial insurance carriers, and Self-Pay patients and works rejections.

DUTIES AND RESPONSIBILITIES:

  • Submits claims to payers based on review of medical records and in accordance with Medicare, Medicaid, and Commercial insurance guidelines as well as FHCSWF policies and procedures.
  • Reviews information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information to ensure clean claim submission.
  • Enters charges accurately and expeditiously to ensure proper records handling and fast payment.
  • Timely filing of insurance claims to clearinghouse or individual insurance companies electronically or via paper.
  • Review and correction of claim edits within 24 hours of being received from clearinghouse and internal claims scrubber.
  • Initiates private pay collections after insurance cancellation, denial or other issue and answer patient questions on patient responsible portions, copays, deductibles, write-offs, etc.
  • Performs self-pay patient billing.
  • Prepares and sends patient statements for charges not covered by insurance.
  • Other duties as assigned.

Requirements

KNOWLEDGE:

  • Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment
  • Medical terminology, CPT, HCPCS and ICD-10 coding and modifier usage
  • Understanding of FQHC billing procedures and Sliding Fee Schedules a plus
  • EHR systems expertise, preferably with Intergy or other ambulatory care facility-based system
  • Understand and adhere to all HIPAA guidelines
  • MS Office Suite (Excel proficiency)
  • Alpha-Numeric data entry

SKILLS AND ABILITIES:

  • High School or Equivalent (Associates Degree preferred)
  • 2 Years Medical Billing experience
  • CMRS, CPB, or CPC credentials a plus
  • Attention to detail with strong documentation, analytic and problem-solving skills
  • Ability to multi-task in a fast-paced environment
  • Strong interpersonal written & verbal communication skill

About the Company

F

Family Health Centers of SouthWest Florida