Location:
12901 McGregor Blvd, Fort Myers, FL
Department: Department of Revenue Integrity
Categories: Professional
Type: Full-Time
Shift: 8:00 AM-4:30 PM
Schedule: Days
Description:
Resolves billing issues, and provides coverage guidelines for billable services to reduce or prevent future claim denials. Employs Craneware Online, EPIC WQ workflows, and other accredited resources for assigned cost center(s) to identify potential reimbursement opportunities in a proactive manner. Ensures the appropriate bundling or unbundling of charges, and applicable modifiers applied so that all charges that are submitted result in optimal reimbursement while following applicable billing, coding and reimbursement regulations within respective areas. Interacts with other departmental staff, i.e. BO, HIM and ADT for resolution of third party payer billing disputes. Additionally, resolves CCI edits as appropriate, reviews Medicare intermediary and other third party payer bulletins to keep current on billing requirements and APC payment status and changes. Communicates relevant information to all applicable department personnel. Communicates results through daily interaction and monthly status meeting to the department team. Provides other support as needed.
Requirements:
| Degree/Diploma Obtained | Program of Study | Required/ Preferred |
and/or |
| High School Diploma or Equivalent | Required | ||
| Minimum Years Required | Area of Experience | Required/ Preferred |
and/or |
| 3 Years | Healthcare | Required | |
| Licenses | Required/ Preferred |
and/or |
| Not Required | ||
| Certificates/Registrations | Required/ Preferred |
and/or |
|
Preferred Materials Inc.
|
|
Nextech
|
|
Arthrex, Inc.
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