What are the responsibilities and job description for the Commercial Billing Specialist position at Florida Physician Group Inc?
Job Description
Job Description
Florida Physician Group
FPG Corp Offices
Job Summary
Under the direction of the Directors or designee, the Billing Specialist ensures all Commercial / Managed Care, Medicare and Medicaid claims are reviewed for claim edits, claim submission, and timely follow up, as assigned.
Duties and Responsibilities :
- Review all Manager holds in Athena and resolve the challenges so that the claims are resubmitted clean and are paid in less than 35 days
- Reporting to the Directors and Practice Managers any challenges with consistent issues with staff members quality of work and the need for training or corrective action steps
- Monitor through Athena reporting and provider documentation split shared and incident 2 billing guidelines
- Submit claims to carriers with the appropriate remarks and / or attachments during claims resolution
- Run insurance eligibility and correct claim before submission, as needed
- Pull supporting documents for annual regulatory audits, as needed
- Ensure credit balances are reviewed and resolved timely
- Assist in the charge posting and holds resolution process in all practices, when needed
- Provide education to team when needed and necessary
- Other billing assignments, within skillsets and abilities
- Any other duties as assigned
- Travel to Broward and Dade practices for training
Education
Certified coder Certificate or Degree
High School graduate or equivalent
Experience
Minimum 2-years Commercial / Managed Care / Medicare / Medicaid billing experience in an acute Physician Practice setting billing for Medicare part B fee's
Working knowledge of Common Procedural Terminology (CPT), HCPCS and ICD10 Code
Working knowledge of Federal, State, and Commercial billing guidelines
Language : Bilingual English / Spanish is preferred
