SUMMARY OF POSITION:
Responsible for working and collecting outstanding accounts receivables due from patient and insurance carriers. Posting and managing account payments. Responsible for submitting claims for primary, secondary and appealed claims. Responsible for timely clean claims processing to ensure positive cash flow for all entities managed by Provision Health Partners to include the Provision Center for Proton Therapy, Provision Radiation Therapy Center, and the Provision Diagnostic Imaging Center.
- Reviews and submits clean claims daily to insurance carriers through the clearinghouse
- Manages outstanding accounts receivables
- Prepares written appeals for reconsideration to insurance companies
- Manages denied and partially paid claims for proper processing by the carrier
- Identifies and resolves patient billing issues
- Prepares, reviews and electronically submits patient statements monthly
- Evaluates patient’s financial status and establishes budget payment plans
- Posts electronic payment remittances as well as manual checks to patient accounts
- Performs month end close procedures to include all reports
- Works closely with the finance team with patient care coordination
- High level understanding and working knowledge of CPT Coding and ICD10 Coding
- Ability to read and interpret the local coverage determination policies
- Minimum of two years’ experience working in a medical office/healthcare facility within their billing and collection department primarily working outstanding accounts receivable claims.
- ·Radiation Oncology Coding and Claims Management Experience. Experience with MOSAIQ Billing/EMR Software a Plus.
- Two year degree in business or equivalent experience in a medical office or healthcare facility.
- HS Diploma/GED or Associates/Bachelor’s Degree.
- Certified Coder
- Certified in ICD 10
Provision Health Partners delivers innovative and cost-effective management services that allow healthcare entities to focus on their healthcare business, thereby enhancing their ability to provide quality patient care.
Location/Region: Knoxville, TN (US)