Medical Billing

Position 1 - Charge Entry

Responsibilities

To ensure the accurate and timely entry of all medical services rendered into the billing system, facilitating correct claim submission and optimizing the healthcare provider's revenue cycle.

Key Process Steps & Responsibilities:

• Review Documentation: Analyse patient encounter forms, superbills, operative notes, and other clinical documentation to identify services rendered.
• Code Assignment: Apply the correct CPT (Current Procedural Terminology), HCPCS, and ICD-10 (International Classification of Diseases) codes and necessary modifiers based on the clinical documentation.
• Data Entry: Accurately enter all relevant charge information, including patient demographics, insurance details, date of service, units of service, and billed amounts into the practice management or EHR system.
• Accuracy Verification: Conduct thorough verification of all entered data to ensure accuracy and completeness, minimizing errors that lead to claim denials.
• Discrepancy Resolution: Identify and resolve any discrepancies in documentation or coding by collaborating with coding staff, healthcare providers, and other internal teams.
• Claim Submission: Ensure timely and accurate submission of "clean claims" to insurance carriers, either electronically or via paper, following specific payer requirements.
• Compliance Adherence: Maintain strict adherence to billing and coding compliance guidelines, including HIPAA regulations and specific government and commercial insurance payer rules.
• Reporting and Auditing: Generate and review charge entry reports, participate in quality control audits, and assist with month-end closing procedures.
• Account Follow-up: Monitor unbilled accounts and follow up on claim statuses to ensure prompt processing and address any denials or rejections.

Position 2 - Payment Posting

Responsibilities

• Payment and adjustment posting: Accurately post insurance and patient payments, as well as adjustments, into the practice management system.
• EOB and ERA reconciliation: Review and interpret Explanation of Benefits (EOB) and Electronic Remittance Advice (ERA) to ensure correct application of payments and to identify discrepancies.
• Daily balancing and reconciliation: Perform daily balancing of cash and adjustments and reconcile unapplied cash accounts.
• Discrepancy resolution: Identify and resolve discrepancies in payments, such as incorrect payments or non-payment issues, by working with other teams like billing and AR.
• Denial and credit management: Post denial information and research credit balances to process refunds or transfers to the appropriate party.
• Compliance: Maintain compliance with industry regulations and company policies.
• Productivity and accuracy: Meet productivity and accuracy benchmarks as per service level agreements (SLAs

Skills and Qualifications:

• Bachelor's degree any stream
• Above 1.5 years of experience in RCM
• Proven experience in RCM process and computer application
• Ability to work on software applications systems and a willingness to learn
• Knowledge in MS office

Experience

Location

Shift:

Who We Are

PracticeSuite is a national, fast-growing cloud computing software company based in Tampa, FL that provides a cloud-based 360°Office Platform to healthcare facilities. PracticeSuite has an agile management team, high employee morale, and high customer satisfaction and retention. PracticeSuite is growing rapidly and is being recognized as one of the 5 top cloud-based systems within healthcare.

Please visit our website to learn more about us, at www.practicesuite.com

PracticeSuite, Inc is committed to equal opportunity in the terms and conditions of employment for all employees and job applicants without regard to race, color, religion, sex, sexual orientation, age, gender identity or gender expression, national origin, disability or veteran status. PracticeSuite, Inc also complies with all applicable national, state and local laws governing nondiscrimination in employment.