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Summary

Major Job Functions

The following is a summary of the major essential functions of this job.  The incumbent may perform other duties, both major and minor, that are not mentioned below.  In addition, specific functions may change from time to time:

• Ensure a highly productive, efficient, and accurate process flow of customer accounts through billing

• Monitors insurance denials through rejection reports, research, processing and follow-up

• Assist in monitoring correct coding and charge entry processes

• Coordinates and monitors all insurance processing

• Troubleshoots software/hardware problems that arise in claims production and nonpayment by carriers when related to claims processing

• Ensures compliance with Federal regulations for maximum reimbursement

• Process claims, edit, corrects errors and transmits to third party payers, intermediaries and/or clearing house for payment

• Post all insurance and patient payments and adjustments

• Review next day schedule for insurance accuracy, patient balances and eligibility

• Other duties as assigned

Minimum Qualifications

The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:

Education and Formal Training: 

• High school diploma or equivalent required

• Certified Coder in Medical or Professional Coding preferred

Work Experience: 

• 3 years of experience in physician office insurance or billing preferred

Knowledge, Skills, and Abilities Required: 

• Proficiency in reading, writing, and speaking the English language

• Good data entry skills

• Familiarity with medical record content and understanding of ICD-CM/CPT4 coding principals

• Ability to assign accurate codes using good judgement within broad guidelines

• Flexible and capable of intense concentration in a busy, noisy and crowded environment

Physical Requirements: 

• Near visual acuity

• Motor coordination to operate computer

• Most work is sedentary

Required Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity