Medical Billing Manager

Position Summary

At Strive! Physical Therapy every team member has a critical role to play in the success of our patients and our company. As a Billing Specialist, your performance is key to our ability to collect payment and revenue from all patient services and insurance claims.

• Primary payment poster. Post all insurance and patient payments, paper and EFT, accurately into the practice management system. Performance target:
  All payments should be posted within 24 hours of receipt, unpaid insurance receivable over 90 days shall not exceed fifteen percent (15%).
• Downloads and processes electronic remittances from third party payers as necessary.
• Resolves the company clearinghouse claim rejections buckets daily.
• Review “Denied” and “Incomplete” company queues in Clinicient daily.
• Demonstrate a high degree of accuracy. Performance expectation:
  Payment and adjustment accuracy should exceed ninety-nine percent (99%).
• Review and print paper claims weekly. Send notes/attachments as required.
• Respond to all insurance inquiries, paper and electronic. Answer patient and insurance inquiries as necessary.
• Reconcile bank ledger with practice management system. Reconciliation is to be performed, at least weekly, in coordination with DOF/CFO.
• Communicates denial trends/patterns to management team.
• Reviews and authorizes patient write-offs.
• Review and transmit (EMC) claims for the company daily.
• Sort paper EOB’s and payments by entity daily. Post payments, Scan checks and EOB’s into the company’s share file for payment posting. Provides bank deposits to appropriate admin. Personnel.
• Supports PSC Lead as necessary. Participate in employee cross training as necessary.
• Keeps abreast of insurance, state and federal healthcare billing regulations.
• Manage all provider enrollment files, including CAQH, PECOA, and EFT/ERA enrollments. Maintain, update, and share insurance participation Grid weekly.
• Sign one-time payer agreements.
• Perform month-end reporting (and period close) no later than 5th business day of the following month.
• Process patient and insurance refunds per company policy.
• The list of Position Responsibilities is not exhaustive and may later be supplemented.

• A minimum of 3 years of healthcare office experience, and/or
• 3 years’ experience in medical billing / coding / collections (required)
• Working knowledge of CPT-4 and ICD-10 coding required. CPC Preferred.
• Functional knowledge of Explanation of Benefits (EOB’s) and understanding of copays, coinsurance, deductibles and denial codes required.
• Proficient customer service skills. Working knowledge of MS Office and databases.
• BA in business administration, business management (preferred)
• Able to work from our office located in Ocala, Fl.
  
  - Maricamp Rd. (NOT remotely)