Professional Billing Spec

Job Description

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children's Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Position Summary

Progressively responsible for revenue cycle functions related to government, managed care, commercial, third party, grant funds, and other payers for a multispecialty physician organization.

Responsibilities

1.Review and make all necessary corrections to claims that do not pass the billng edits.

a.Process all claims through clearinghouse software and correct errors and rejections to insure claims reach third party payers correctly and efficiently.

b.Update billing and clearinghouse, as needed, to insure claim and processing information is complete and correct.

c.Provide updates and feedback to management and operational users regarding integrity of claim information.

2.Promptly post all payments and remittance advice information and reconcile billing system, banking deposits, and posting documentation.

a.Post all payments, adjustments, and denials daily.

b.Maintain reconciliation spreadsheets daily.

c.Provide information to management and financial accounting department regarding cash collection and adjustments.

3.Address, adjudicate, and rebill all third party claim denials and outstanding claims, as necessary.

a.Aggressively perform follow-up duties on all third party claims on a timely basis.

b.Rebill claims as necessary to secure payment for services rendered.

c.Write off non-collectible amounts in agreement and coordination with management and administration.

4.Produces and understands various reports related to revenue generated A/R and A/R aging.

a.Use report information to perform claim reconciliation and A/R management in an efficient and targeted manner.

b.Generate and maintain scheduled reports as instructed.

c.Documents all billing and collection activities in a standard format.

5.Performs other related responsibilities as requested or required.

a.Participates in CQI activities.

b.Demostrates Service Excellence

c.Addresses all billing and insurance questions that are encountered.

Minimum Requirements

Associate degree or higher in Accounting, Business or related field

3-5 years experience in medical billing office, agency or third party payor organization that bills for physicians' services preferred.

Experience may be substituted for education. One year of relevant experience is the equivalent of one year of education.

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant's qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.

Contact Information

For additional information, please contact:

Angie Nichols, Talent Acquisition Consultant

ECU Health Talent Acquisition

Email: