GA Med Group
– a place where you’ll be valued, recognized and rewarded for the vital work you do each day. We’ll surround you with a strong team and leadership that supports every aspect of your life – both inside and outside of our centers. And you’ll get to practice your passion in a non-profit, mission-driven organization that’s known for the highest level of care in our communities
ESSENTIAL DUTIES AND RESPONSIBILITIES
- Processes medical insurance claims, including submitting claims electronically and following up on denied or outstanding claims.
- Develops and implements processes that support accurate use of medical codes used by the practice and compliance with industry standards and regulations.
- Interacts with providers and educates them about documentation and coding best practices.
- Maintains an up to date knowledge of key rules and common practices as it relates to reimbursement.
- Follows up with providers on documentation that is insufficient or unclear.
- Reviews patient charts and documents to ensure all codes are active and accurate.
- Oversees the revenue cycle of the practice, including patient registration, charge capture, and payment posting (in collaboration with Financial Services team).
- In coordination with the contracted billing agency, prepares and provides regular month-end reports to the practice's leadership, including accounts receivable and insurance claims reports.
- Manages patient billing, including issuing invoices, if applicable, following up on past-due accounts, and resolving billing disputes.
- Maintains accurate accounts receivable records and follows up on outstanding payments.
- Verifies patients' insurance coverage, including copays, deductibles, and benefit limits.
- Provides education and training to practice staff on billing and coding processes, as well as HIPAA and insurance regulations.
- Manages patient information, including demographic information, insurance information, and appointment information.
- Business office duties as directed by Senior Director of Practice Management for Physician Services.
- Collaborates with Health Informatics and Recruiting Program Director to collect data to support accurate claims billing.
- Identifies problematic issues and immediately reports discrepancies and provides appropriate recommendations to leadership.
- Promotes the image and reputation of the System by exhibiting servant leadership and providing direct and open lines of communication.
- Contributes to the work of committees, workgroups, project management, and other collaborative efforts of the System.
- Performs other duties as necessary to ensure the success of the System.
SKILLS AND ABILITIES
- Knowledge, experience and aptitude with all aspects of the medical practice billing cycle
- Knowledge and compliance with rules and regulations governing payments from Medicare, Medicaid, and insurance companies.
- Knowledge of anatomy and medical terminology
MINIMUM QUALIFICATIONS
- High school diploma
- Associates degree, preferred
- Minimum of 3 years of medical coding and billing experience
- Strong working knowledge of ICD-9, ICD-10, CPT Codes
- Certified Professional Coder certification, preferred
- Prior experience with at least one EHR and revenue cycle management software
EEO / M / F / D / V / Drug Free Workplace
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