About this role
Job Summary
Performs collection functions for First Physician Group. Reviews charges and verifies appropriate usage of modifiers, CPT-4, ICD-9 and ICD-10 code ensure appropriate reimbursement. Analyzes and corrects claims to ensure accurate and timely claims submission. Sets up account for Client Services and collects past due balances. Responsible for resubmission of claims for additional reimbursement and/or appealing said claims with timely follow up. Responsible for calculating and posting contractual allowances accurately and timely keeping the AR to a minimum. Responsible for incoming and outgoing mail. Researches and answers customer’s questions regarding billing disputes. Interacts with FPG Physicians, Office Managers, CBO staff, and other appropriate SMH staff to review coding and billing issues. Responsible for keeping abreast of and complying with all third party regulations. Responsible for ensuring all fee schedules are kept current and MMS updated. Handles all correspondence and all communications in a timely manner. Job knowledge is section specific. Ability to demonstrate Customer Service Recovery, be flexible and adapt to changes in growth within the CBO Department.
Required Qualifications
- Require an Associate’s Degree. A high school diploma, plus two (2) years of relevant Patient Financial Services or related experience, may be substituted for required degree.- Require the ability to manage special projects and task to completion.- Require the ability to be cross-trained in two (2) or more specialty areas.- Require general knowledge of ICD-9, ICD-10 and CPT coding.- Require the ability to analyze problems, develop solutions and consistently follows through to resolution.- Require the ability to meet and greet public and handle difficult situations diplomatically.- Require a clear and distinct speaking voice.- Require the ability to operate an adding machine quickly and accurately by touch.- Require the ability to use standard office equipment.- Require basic mathematical, organizational, and communication skills.- Require basic knowledge of Managed Care remittance and adjustment process.
Preferred Qualifications
- Prefer three (3) years of experience working with Medicare, Medicaid and commercial billing and collections.- Prefer three (3) years of experience in utilizing Windows based software applications.- Prefer the ability to type fifty (50) words per minute for CRT and PC input.- Prefer financial or banking experience.
Mandatory Education
Preferred Education
Required License and Certs
Preferred License and Certs
Employment Screening Requirements
As part of Sarasota Memorial Health Care System’s commitment to keeping people safe, all individuals providing care to vulnerable populations are required to undergo background screening through The Florida Care Provider Background Screening Clearinghouse. https://info.flclearinghouse.com/Other facts
About Sarasota Memorial Health Care System
Sarasota Memorial Health Care System is a regional referral center offering Southwest Florida’s greatest breadth and depth of care, with more than 2,500 medical staff and more than 1.7 patient visits across its two hospital campuses, two freestanding ERs, and network of outpatient care centers.
Its flagship 897-bed Sarasota hospital has been consistently recognized as one of the nation’s best, with superior patient outcomes and a comprehensive network of services. In 2021, the public health system opened its second acute-care hospital, SMH-Venice, with 212 beds and full range of specialties to serve south Sarasota County. As the region's only public health system – and only not-for-profit – it also serves as a critical safety net for the uninsured and underinsured in Sarasota County.
What you'll do
- The Support Service Rep II - Patient Account Specialist performs collection functions, reviews charges, verifies coding, and ensures accurate claims submission. They also interact with various staff to resolve billing issues and maintain compliance with regulations.
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