Accept the Challenge…Make a Difference
University of Florida Jacksonville Healthcare, Inc. has supported the University of Florida's physician practice in Jacksonville and other northern Florida and southern Georgia communities since 1971. UFJHI provides a wide range of business services to one of the largest mixed specialty practices in the southeastern United States consisting of over 300 physicians working in 30 clinics. UFJHI is an exciting and challenging place to work. We really care about the communities and patients that we serve. Our employees work alongside nationally and internationally renowned physicians who are engaged in teaching and research as well as providing healthcare services. Primarily located in Jacksonville, Florida, UFJHI also offers a great north Florida lifestyle with countless recreational activities, museums, orchestras along with professional and amateur sports.
Scope of the Job
Responsible for obtaining appropriate demographic and financial information. Registers patients and completes necessary documentation. Add or change patient histories as needed. Research charges for appropriate carrier code and financial class. Code and key physicians’ charges into automated billing system program. Utilize resources and tools in the resolution of invoices following company policy for assigned payor/s. Resolving outstanding balances with communication with internal and external customers.
The essential functions are the primary dimensions for performance review.
Verify completeness of registration information. Add and/or update as needed.
Verify and/or assign financial class.
Verify and enter patient demographic information utilizing automated billing system.
Verify insurance coverage utilizing various online software tools.
Verify and enter appropriate billing information utilizing facility computer systems.
Verify and/or assign CPT, ICD-9 and Modifier codes are utilized for each patient encounter as needed.
Verify and/or assign key data elements for charge entry such as, location codes, provider #’s, authorization #’s, referring physician and etc.
Ability to recognize the need to establish a case utilizing company policy.
Ability to enter charge information into automated billing system.
Ability to correct edits timely and appropriately.
Inform team leader on the status of work and alert team leader of backlogs or issues requiring immediate attention.
Contact insurance companies to ascertain the status of claims and identify additional information needed.
Research and take appropriate action in regards to refunds, payor issues, charge corrections, etc. with the ability to identify trends.
Ability to identify payor specific guidelines, billing edits, National Correct Coding Initiative and online tools.
Documents notes in the automated billing system regarding patient inquiries, conversations with insurance companies, clinics, etc, for all actions.
Re-file insurance claims when necessary to the appropriate carrier based on each payors specific appeals process with the knowledge of timelines.
Complete correspondence request through interaction with payors, patients and /or the clinics to provide needed information for claims payment.
Review PSR requests and determine course of action.
Inform team leader of the status of work area and alert team leader of backlogs or unresolved issues.
Identify trends by payor that impact A/R and communicate to leadership (Denials, payment transfers, etc.)
Perform special projects assigned by the team leader.
All other duties as assigned by team leader or manager.
Must be able to perform under stress when confronted with emergency, critical, or unusual situations. Must be capable of dealing with periodic cyclical workload pressures and levels of responsibility. Required to make independent judgments without supervision. Must be able to make generalizations, evaluations, or decisions based on sensory or judgmental criteria. Must have the adaptability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure. Requires the ability to work with people beyond giving and receiving instructions.
SKILLS, QUALIFICATIONS, AND REQUIRED EXPERIENCE
Strong analytical and problem solving skills;
Effective interpersonal and communication skills;
Ability to work as a team is essential to the individual’s success;
Strong telephone skills;
Ability to operate standard business equipment e.g. copier, fax machine.
At least two (2) years of health care experience in medical billing or related position required.
Computer experience in medical billing preferred, prior IDX system experience preferred;
Knowledge of third party reimbursement;
Experience with Allscripts, Medifax, MedData and other online payor tools preferred;
Knowledge of CPT-4 and ICD-9 coding and medical terminology;
Strong PC Skills preferred;
10-key proficiency desired;
Light typing (35 WPM).
Education and Certifications
High school graduate
Two years college preferred
Medical Terminology Course