Physician Billing Coordinator, Ophthalmology, FT, Days

Prisma Health
United States, South Carolina, Columbia
Nov 05, 2024
Inspire health. Serve with compassion. Be the difference. Job Summary Responsible for the accurate and timely posting of all charges, payments, adjustments and denials into the Practice Management System. Balances totals of all financial activity posted to patient accounts prior to daily close. Performs daily closing of assigned datasets and provide appropriate documentation to be archived. Generates patient statement and insurance claim files as instructed. Transmits batches electronically according to established procedures. Facilitates processing of all active claims and statements. Performs account collections. Provides customer service for patient account inquiries. Essential Functions All team members are expected to be knowledgeable and compliant with Prisma Health's values: Inspire health. Serve with compassion. Be the difference. Accurately post all charges, payments, adjustments and denials. Perform daily close out procedures and advance the date in the Practice Management System. Create claim batches and process them via electronic submission. Manually process any claims that are not eligible for electronic billing. Identify any claims that need attention, make corrections and resubmit. Transfer open items to secondary insurance when appropriate. Utilize appropriate codes when posting charges into the Practice Management System. Ensure coding to the highest level of specificity and for maximum reimbursement by third party payers. Capture information from patient's medical record when necessary to properly code both procedures and diagnoses. Receive and answer telephone and written inquiries regarding patient accounts. Explain payment and settlement process to patient and third-party payers. Review past due accounts and prepare for bad debt write off. Contact insurance carriers and/or patients for immediate payment. Set up payment arrangements according toestablished guidelines when necessary. Provide duplicate billings, coordination of benefit information and medical records when need to expedite payment of open items. Identify accounts with credit balances and process refund check requests. Monitor claims for appropriate processing. Submit appeals correspondence to third party payers when claimprocessed incorrectly. Post comments on patient account to reflect all actions made. Effectively utilize time and resources in order to meet performance goals. Clearly communicate any billing related issues to Billing Manager. Maintain current knowledge of departmental and organizational policies. Performs other duties as assigned. Supervisory/Management Responsibilities This is a non-management job that will report to a supervisor, manager, director or executive. Minimum Requirements Education - High School diploma or equivalent OR post-high school diploma / highest degree earned Experience - Three (3) years related experience In Lieu Of NA Required Certifications, Registrations, Licenses NA Knowledge, Skills and Abilities Computer literate. Familiar with general charge entry procedures Ability to work independently Strong problem-solving capabilities Working knowledge of ICD-9, CPT, NCCI and Medicare LCDs Familiar with modifier application and standard billing regulations Ability to read and comprehend insurance remits Ability to communicate well with others Experience with current Practice Management System preferred. Work Shift Day (United States of America) Location 100 Palmetto Health Pky Parkri Facility 3104 Ophthalmology 100 PH Pkwy 350 Department 31041000 Ophthalmology 100 PH Pkwy 350-Practice Operations Share your talent with us! Our vision is simple: to transform healthcare for the benefits of the communities we serve. The transformation of healthcare requires talented individuals in every role here at Prisma Health.