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CAIPA MSO LLC

Billing Coordinator

CAIPA MSO LLC, Jersey City, New Jersey, United States, 07097


Description: The Billing Coordinator (Generalist) is responsible for multiple components of the billing process, including Charge Entry, Edits, Payment Posting / Reconciliation, Accounts Receivable (denials and appeals). Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution.

Duties:Verifies insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissionsEnters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and proceduresMay run workbench reports and communicate with appropriate parties for missing chargesPosts payments / adjustments from paper EOBs and ERAs using approved methodologies with strong reconciliation skills.May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staffWorks system edits and clearinghouse rejections. Proficient in moderate to complex encounters and problematic accountsWorks daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claim statuses, re-submits claims, edits, denials and process appeals which includes submit claim reconsiderations and writes appeal letters on a timely basisResearches unidentified / missing checks and communicate with appropriate parties for replacementsWorks credit balance report to ensure adherence to government regulations/guidelinesAnalyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendationsIdentifies and assists in resolves credentialing issuesMeets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concernsMentors less experienced Billing staff and assists Billing Manager/FPA Manager in training new staffMay be responsible for collection of time-of-service payments, and maintaining daily transaction record of collected paymentsMaintains working knowledge and current in third party payer requirementsRequirements:

Associates Degree or high school diploma/GED plus 3 years of relevant experienceCPC PreferredTrained in computerized medical billing3 years' experience in medical billing or health claims in a health care or insurance environment, and familiarity with ICD/CPT codingBenefitsHealth Benefits: Medical, Vision and Dental401k retirement planPaid Time OffHybrid Work ModelSalary Range:40k-60k

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