Billing Specialist Jobs

Are you looking for not only a Job but a career? Are you over worked? Are you tired of working weekends missing out on family time, activities or just peace and quiet on Sunday?

At Women's Care our employees only work Monday through Friday no WEEKENDS! Women's Care offers that and so much more. We offer great competitive pay and the availability to grow within our organization. We believe in team work and loving what we do every day. Women's Care was founded in 1998 by a small group of obstetrics and gynecology physicians in Tampa. Our organization has grown tremendously through the years by remaining true to its mission of improving the health of our patients every day. We are looking for individuals to come join and grow within our team and continue to make a difference in Women's Care. Please consider us as your future home.

The overall operational responsibility for the billing and coding functions through billing and clerical staff including front desk, authorization/verification, and charge entry to ensure billing and coding compliance while continuously improving accounts receivable for the Unit.

How you'll contribute

• Approve refund check to be issued to patients
• Continuously monitor utilization of payer and system resources to ensure accuracy of insurance verification process
• Constantly review payer denial trends. Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers when necessary
• Monitor cord blood log and track payments monthly
• Reviews, coordinate and implements claim reimbursement methodologies to ensure accurate and timely collection of revenue
• Training and development – meets the coding/billing needs and objectives of the Unit through ongoing training and development of staff and providers
• Charges are reviewed to detect for variations and patterns in order to prevent lost revenue this includes daily balancing all payment and charges
• Generate practice activity report for service date and sort on entry date to determine lag days between date of service and date charge was entered in eCW
• Decreases days in A/R by ensuring all office charges are entered within 1 day from date of service and hospital charges are entered within 5 days from date of service
• ECW pre check to determine in house collection balance, collection agency, credit balances
• Generate insurance aging report to review details of unpaid claims
• Accuracy measured by number of monthly electronic transactions for the Units (includes, eligibility & benefits and claim status)
• Problem solving – Provides feedback and input to assist in resolving any billing/coding problems. Contributes to putting plans in place to avoid recurrence and ensure improvements where necessary
• Continuously increases utilization of managed care tools and improves eligibility and benefit
• Review monthly benchmark data distributed by CBO
• Review EOBs and financial history to determine accuracy of credit balance
• Staff and provider resources – always appropriate in terms of performance, ability, attitude and capacity. Counsels, disciplines and/or recommends termination of employees as required
• Review patient credit balances and approve refunds bi monthly
• Generate daily recap to determine total refunds issued given a specific period
• Customer Service – Maximizes patient experience by assisting the patient with understanding their financial obligations. Reviews and handles patient billing complaints
• Review Insurance follow-up module office responsible worklist to determine coding errors and manage denials
• Review financial analysis report of all patient responsible debt sorted by statement code
• Consistently use Encoder Pro and other coding resources ie. payer reimbursement guide and insurance web portals to ensure coding accuracy
• Ensure constant use of managed care tools and references
• Systems and processes are documented, adhered to and continuously improved. Includes:
• Generate SPLIT bill report monthly to ensure charge capture of antepartum
• Oversees and ensures compliance with all WCF billing/collections policy and procedures
• Reviews lab and ultrasound service utilization, physician charges and coding accuracy, and capture of charges
• Review the C5 worklist in the patient collection module and report status of delinquent accounts. Reviews accounts and determine if account should be placed with an outside collection agency
• Review OB Budget agreements and ensure collection of monthly budget installments
• Use insurance web portals and patient responsible estimators to determine patient financial responsibility
• Oversee time of service collections process in accordance with WCF financial policies
• Randomly select encounter and compare to documentation
• Monitor and review patient responsible collection module and collection processes monthly
• Continuously monitors and reviews Unit specific benchmarking reports and provides recommendations for improvement
• Constantly monitor credit balance worklist in patient collection module
• Develops and maintains effective communications between all levels of personnel
• Ensures timely and accurate entry of charges, visit encounters and receipts into the eCW system
• Review and process all claims on the "on hold” in the Insurance Follow-up module weekly

Who you are

• Working knowledge of electronic claims submission and remittance procedures
• 3+ years billing experience in medical office environment is preferred
• OB/GYN experience a plus
• ECW electronic medical record experience a plus
• Ability to multi-task in a stressful, deadline-oriented environment
• Ability to use a computer and enter data in electronic medical record system
• CPC required
• Knowledge of governmental regulations and compliance requirements
• Ability to interpret financial statements
• Minimum three years medical coding and medical billing experience in medical office environment
• 2+ years of billing supervisory experience is preferred
• Ability to communicate with coworkers, providers and patients in an effective manner
• High school diploma or equivalent

Women’s Care, founded in 1998, is a leading women’s healthcare group in the United States, dedicated to providing the highest quality of care for women through their reproductive years and beyond. With 110 locations and over 400 OB/GYNs and specialists across the country, Women’s Care provides comprehensive patient care in obstetrics, gynecology, gynecologic oncology, urogynecology, gynecologic pathology, breast surgery, genetic counseling, maternal fetal medicine, laboratory services, and fertility.

Women’s Care has grown tremendously through the years and expects to accelerate its growth with plans to expand rapidly into new markets across the U.S. With the commitment of our employees, we remain true to our mission of ‘Improving the Health of Women Every Day.’ At Women’s Care, we CARE about our patients, and we stand by our values.

Compassion & Empathy: Treating patients like valued friends and family

Accountability: Taking responsibility for our actions and behaviors

Respect: Acting respectfully in every interaction

Excellence & Quality: Providing the safest, highest quality of care

We are looking to grow our team with equally value-driven professionals who are passionate about using their skills to further our mission. We value our employees just as we value our patients, and we prioritize advantages like work-life balance, employee engagement, and other incentives to help you be your best. Now is a great time to join our team!