Senior Billing/Account Representative (Certified Professional Coder certification required)

For more than 45 years as a multi-specialty, privately-owned practice, Raleigh Medical Group has realized that there is more to quality health care than state-of-the-art medicine.
In today’s complex medical environment, our internists like to keep things simple: we focus and prioritize our patients' needs.
We tailor our treatments to provide patients with the finest personalized health care available for each stage of their adult life.
We understand that when our team members are taken care of, so are our patients.
Each day we strive to support our team, give them the resources needed to grow, and create an enjoyable work environment.
Our organization continues to grow, and so does our team! We are looking for a *Senior Account Representative* to join our group.
Please note this is an in office position, Monday through Friday.
*Does this sound like a fit? Check out the details! * The *Senior Account Representative* performs functions critical to managing cash flow and accounts receivable by follow-up on unpaid claims and outstanding patient balances by maintaining all accounts receivable workflow, procedures, coding, and billing as per departmental and company policy.
*We Offer Our Valued Employees:* * Group Health, Dental, and Vision * FSA and HSA options * Generous Paid Time Off (PTO) * 401(k) Retirement Plan with matching * Company provided Short-Term and Long-Term Disability * Company provided Life Insurance * Competitive Salaries * Annual Employee Appreciation Events *On an average day, you will: * * Reviews daily charges for errors prior to claim submission and close batches prior to close of day.
* Follows-up on aging insurance claims and files secondary/tertiary claims.
* Handles patient correspondence, phone calls, and walk-ins in a professional and courteous manner.
* Reviews and appeals claim denials as needed.
* Troubleshoots failed claims in system.
* Reviews credit balance accounts for possible overpayments or erroneous adjustments.
* Transfers patient credits to open vouchers prior to processing patient refund requests in a timely and accurate manner.
* Review credit balances and request weekly refunds for divisional refunds, patient refunds and insurance refunds.
* Post Divisional refunds weekly, transfer money from professional vouchers to facility vouchers.
* Works with billing and posting staff to expedite re-files, refunds, or other payment related issues.
* Processes adjustments and write offs per department policy and provide supporting documentation.
* Review and correct Productivity report discrepancies every month * Performs back-up duties with charge entry such as office visits, pathology, infusion, and facility procedures.
* Reconciles the missing ticket report and forwards charge data to the appropriate representative to process.
* Ensures patient demographic and insurance information is updated in timely manner.
* Maintains strictest confidentiality and complies with Health Insurance Portability and Accountability Act (HIPAA) regulations.
* Maintains the security of protected health information (PHI), including what PHI access is allowed and the reason for access to PHI.
* Communicates with physicians to convey proper coding and billing policies.
* Handles complex AR follow-up and troubleshoots claims from singular instances to broad claims issues, including contract issues.
* May handle some administrative functions falling outside the scope of AR.
* Provide training and knowledge sharing with peers and new employees.
* Review/Audit procedure and office visit documentation for correct coding.
*To qualify for this job you must have: * * High school diploma or equivalent.
* Five years of experience in physician billing/insurance follow-up and A/R related experience in healthcare organization.
* CPC certification (Certified Professional Coder) * PM/EHR experience.
* Medical Terminology, CPT and ICD-10 knowledge.
* Excellent phone communication skills, with the ability to communicate effectively with patients, coworkers, physicians, and nurses.
* Time management, problem solving, multitasking, organizing, and prioritizing skills.
* Strong computer skills which should include Excel along with excellent data entry skills.
* Clear and concise note taking.
*Physical requirements and work environment:* * Sitting for approximately 90% percent of the day.
* Prolonged periods of walking, standing, bending, and reaching.
* Manual dexterity using a calculator or keyboard.
* Fine motor skills.
* Visual acuity.
*EEO Statement: * Raleigh Medical Group is an equal opportunity employer committed to workplace diversity.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, protected veterans status, status as a disabled individual, or any other protected group status or non-job characteristic as directed by law.
Job Type: Full-time Benefits: * 401(k) * 401(k) matching * Dental insurance * Employee assistance program * Flexible spending account * Health insurance * Health savings account * Life insurance * Paid time off * Retirement plan * Vision insurance Schedule: * Monday to Friday Work setting: * Office Application Question(s): * What is your desired salary? Ability to Relocate: * Raleigh, NC 27612: Relocate before starting work (Required) Work Location: In person