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Business Office Rep Urology

1814 New Hanover Medical Park Drive
Wilmington, NC
Job ID: 10949
Date Posted: Nov 3, 2022

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Job Description

Description

About NHRMC

NHRMC, established in 1967 in Wilmington, NC, is recognized as a preeminent healthcare organization focused on leading our community to outstanding health. We have an 855 bed network of hospitals and multi-specialty physician group practices with more than 200 physicians. With a network of primary, specialty, neighborhood clinics and regional medical centers; you will find our culture is the very definition of best in practice. Join us and find out how many ways NHRMC offers you the chance to focus on what really matters - our patients and community.

About the Job

Location: Atlantic Urology

Department: Atlantic Urology

Full Time Equivalent: Fulltime

Work Type: 64 to 80 Hours Pay Period

Work Schedule: 8 Hr Day Shifts 

Exempt from Overtime: Exempt: No

What You'll Do

Summary:
The Business Office Representative is responsible for the primary functions of the Practice Business office. Responsibilities include, claims reviews, billing inquiries and insurance issues and/or patient concerns.


Responsibilities:

Responsibility II: Billing

• Ensures physician charges are applied to the correct patient account by verifying information indicated on charge document against system information.
• Perform limited ICD-9 and CPT-4 coding from charge slips, encounter forms, or source documentation.
• Research credit balances and request refunds appropriately.
• Communicates with manager any emerging denials, trends, etc

Responsibility III: Claims
• Ensures billing and filing of insurance by Central Billing Office (Professional billing) and System Billing Office (Technical or Facility billing) is completed accurately and in accordance with requirements of third party intermediaries
• Follow-up with insurance companies and inquire on claim status of any unpaid claim aged 45 days guidelines
• Recognizes EOB denial, payment and pending remark codes
• Maintain a working knowledge of insurance appeals processes and be proficient in writing an appeal letter


Responsibility IV: Insurance
• Utilize telephone and internet to verify insurance benefits for new patients and patients scheduled for comprehensive examinations for all locations. Provide insurance verification forms to reception staff prior to patient appointments.
• Accurately update patient demographic information as provided by patients and/or insurance companies

Responsibility V: General Practice Duties
• Knowledge of Fair Debt Collection Practices Act, PHI, HIPAA as well as other State and Federal regulations pertaining to health insurance statutes
• Ability and flexibility to cover various medical offices when needed
• Performs cash management protocols as assigned
• Adheres to company policy on continuing education programs, i.e. Annual HIPAA training
• Adheres to departmental dress codes as observed by director and wears picture identification badge, 100% of the time.

Position Requirements

Credentials:

Education:
Essential:
* High School Diploma

Other information:
Experience: At least 1 year previous medical office experience working within a patient registration, insurance verification, claims analyzing or billing role. Demonstrates standards of performance (ownership, teamwork, communication, compassion) that support patient satisfaction and principles of service excellence.
Performs other duties as assigned.
Individual will possess commensurate combination of education, experience and qualifications.

Other Information

This position description has been designed to indicate the general nature and level of work performed by employees within this classification. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications which may be required of the employee assigned to the position. Depending on the location of the job, duties may vary. Receipt of the job description does not imply nor create a promise of employment, nor an employment contract of any kind; my employment with the Company is at will.

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