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Billing Representative Clerk

2 months ago

Ocala, United States SCA Health Full time

Overview:
Today, SCA Health has grown to 11,000 teammates who care for 1 million patients each year and support physician specialists holistically in many aspects of patient care. Together, our teammates create value in specialty care by aligning physicians, health plans and health systems around a common goal: delivering on the quadruple aim of high-quality outcomes and a better experience for patients and providers, all at a lower total cost of care.

As part of Optum, we participate in an integrated care delivery system that enables us to support our partners as they navigate a complex healthcare environment, Only SCA Health has a dynamic group of physician-driven, specialty care businesses that allows us to customize solutions, no matter the need or challenge:

- We connect patients to physicians in new and differentiated ways as part of Optum and with our new Specialty Management Solutions business.
- We have pioneered a physician-led, multi-site model of practice solutions that restores physician agency by aligning incentives to support growth and transition to value-based care.
- We lead the industry in value-based payment solutions through our Global 1 bundled payment convener, that provides easy predictable billing to patients.
- We help physicians address everything beyond surgical procedures, including anesthesia and ancillary service lines.

The new SCA Health represents who we are today and where we are going—and the growing career opportunities for YOU.

Accountabilities / Responsibilities:
We are seeking a Full Time experienced ASC Biller who is a reliable, detail-oriented, takes initiative, is a skilled problem solver, self-directed and able to work independently, and who has a positive and cooperative work ethic Possess basic knowledge of medical terminology and health insurance billing.
- Possess knowledge of typing, word processing, spreadsheet preparation, and computer billing systems.
- CPT & ICD 10 knowledge.
- Daily transmittal to Coding Team of H&Ps, Operative Reports, & any other correspondence required to accurately code cases.
- Accurately bill CPT Codes, implants, and supplies per the UBO’s Billing Protocols.
- Ability to accurately calculate implant, supply, and pharmaceutical implant mark-up and reimbursement.
- Submitting accurate primary & secondary insurance claims to insurance providers following agency and payer guidelines.
- Performing accurate Time of Billing adjustments for procedures, implants, and supplies based on the appropriate contract.
- Knowledge of multiple insurance contracts, Medicare, and W/C Fee Schedule.
- Responsible for daily reconciliation of charges posted (Daily Summary Report, Open Transaction Report, & Daily Posting Report) and uploading these documents to SharePoint.
- Manages unbilled cases by providing ample notes in PAS and reporting to Business Office Manager on a weekly basis what is required to bill.
- Verifies and resolves all rejections in electronic claim clearinghouse, prepares and mails UB claims, and gathers appropriate medical records to send with claims sent via mail.
- Participates in any other business office functions as needed and at the direction of the Business Office Manager.

Qualifications:

- High school diploma or GED certificate
- Possess basic knowledge of medical terminology.
- Possess knowledge of health insurance billing.
- Possess knowledge of typing, word processing, spreadsheet and computer billing systems.
- Ability to handle confidential information.
- Ability to work independently and as a self-starter with a high level of initiative
- Ability to multi-task.
- Strives to be professional, courteous, helpful and cooperative
- Good computer and typing skills
- Good communication skills, strong emphasis on excellent customer service

Min: USD $16.00/Hr. Max: USD $19.00/Hr.

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