Patient Revenue Cycle Representative - Billing Specialist

We are seeking a dynamic and detail-oriented Patient Revenue Cycle Representative - Billing Specialist to join our healthcare team. In this vital role, you will be responsible for managing the billing and coding processes that ensure accurate and timely reimbursement for patient services. Your expertise will help streamline revenue cycle operations, improve cash flow, and enhance patient satisfaction. This position offers an exciting opportunity to contribute to a collaborative environment dedicated to delivering exceptional healthcare experiences.

Responsibilities:

• Read and interpret medical record documentation to identify all diagnoses and significant procedures coding for all facility-based charges and enter charges for billing
• Assist with pre-procedure coding for authorizations
• Work closely with the Surgical Coding Team to compare data with source documents and enter the billing information provided
• Obtain operative reports, review surgical schedules, billing sheets, and authorizations for surgical cases
• Assist with charge entry and billing for IMEs, Cryo/DME, and Miscellaneous attorney reports
• Ensure all codes coded have been correctly pre-certified; if not, send back for updated/retro authorization
• Research and update missing or incorrect information to ensure prompt payment
• Contact physicians for clarification when needed to ensure accurate charge entry
• Answer phones and provide timely communications to patients, vendors, attorneys, and insurance companies
• Assist with verifying insurance eligibility and coverage
• Assist in collecting patient payments, setting up payment plans, and collecting deposits
• Ensure timely follow-up and resolution of billing issues
• Meet daily and weekly goals in a fast-paced environment to ensure prompt billing processing
• Resolve claim holds daily for clean claims transmission
• Maintain current knowledge of healthcare billing laws, rules, regulations, and developments
• Run weekly and monthly financial and miscellaneous reports

Qualifications:

• High School Diploma
• 1-3 years of medical billing and charge entry experience
• Orthopedic experience preferred

Certifications:

• Preferred: Certified Professional Coder (CPC) through AAPC or Certified Coding Specialist (CCS) through AHIMA