Billing/Collections Specialist at Center for… · Royal…

BILLING/COLLECTIONS SPECIALIST Center for Bone & Joint Surgery of the Palm Beaches is a multi-location medical practice devoted to the diagnosis and treatment of injuries and diseases of the body's musculoskeletal system. Our locations feature a staff of highly trained orthopedic surgeons, each with a specific area of expertise. Center for Bone & Joint Surgery of the Palm Beaches offers a team approach to your care and provides a variety of services right on campus designed for your convenience and ensuring an outstanding continuum of care. These include on-site X-ray, on-site MRI, on-site physical therapy, and aquatic therapy. As Center for Bone & Joint Surgery of the palm Beaches continues to grow, we are looking for a Billing/Collections Specialist. Please see below for the functions and requirements for this position. ESSENTIAL FUNCTIONS • Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards. • Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers. • Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections. • Updates and confirms as necessary to allow processing of claims to insurance plans. • Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients. • Attaches referrals/authorizations to appointments/charges if available. • Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals. • Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines. • Completes daily requests and working through obstacles on account balance to ensure maximum reimbursement. • Identifies and communicates trends and/or potential issues to management team. • Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office. • Other duties as assigned by leadership. • Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections. • Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans. • Verifies receipt of claim with insurance plans, determining the next appropriate action steps and timeliness of claims maximum reimbursement. • Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients. • Obtains and attaches referrals/authorizations to appointments/charges. • Maintains productivity and accuracy metrics per department expectations and AEIOU Behavioral Standards. • Assumes full responsibility of reducing the accounts receivable of insurance balances by working through outstanding accounts. • Analyzes accounts for proper claims processing and payment posting through inquiries from patients or staff. • Identifies and communicates trends and/or potential issues to management team. • Follows and maintains all HOPCo policies and procedures, including those specific to billing and the Revenue Cycle. At Center for Bone & Joint Surgery, we are dedicated to taking care of you so you can take care of business! Our robust benefits package includes the following: • Competitive Health & Welfare Benefits • Monthly $43 stipend to use toward ancillary benefits • HSA with qualifying HDHP plans with company match • 401k plan with company match • Employee Assistance Program that is available 24/7 to provide support • Paid Time Off • Paid Holidays • Mileage reimbursement • and more... #CBJ