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Physician Billing Representative II
ChristianaCare. Review, analyze, and initiate appropriate action for denial resolution .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in physician billing and coding, including thorough knowledge of CPT4 and ICD10 codes, as well as the revenue cycle process. Proficient in communication with payers and patients to resolve billing discrepancies and ensure proper reimbursement.
Highest-signal resume keywords
Physician Billing/Coding ExperienceCPT4 and ICD10 KnowledgeEpic ExperienceRevenue Cycle Process UnderstandingCARC/RARC Codes Knowledge
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Denial ResolutionClaims ProcessingAuthorization ResearchBilling Information ReviewPatient Financial Services Procedures
Soft Skills
Written and Oral CommunicationJudgment and TactAbility to Act Independently
Tools & Technologies
Epic
Industry Keywords
Medical TerminologyPhysician Office PracticesPayer PlansUncollected Account BalancesPayment Vouchers
About the role
Key responsibilities & impact- Review, analyze, and initiate appropriate action for denial resolution
- Communicate with payers, medical practices, hospital departments, and patients
- Follow up with third-party insurance companies to resolve unpaid account balances and claims issues
- Work assigned denial and no-response work queues to resolve uncollected account balances
- Conduct authorization research, rebill claims, and process balance write-offs or transfers
- Escalate issues as appropriate
- Review coverage changes and determine whether previously billed charges should be rebilled
- Assign appropriate payer plans and update registration information
- Review encounter documents for completeness and proper CPT4/ICD10 coding
- Ensure claims contain all necessary billing information
- Meet departmental productivity benchmarks
- Submit appropriate documentation and claim forms to third-party payers
- Review payment vouchers to ensure proper reimbursement
- Resolve patient insurance discrepancies with physician office staff
- Perform assigned work safely and report unsafe activities, conditions, hazards, or violations
- Perform other related duties as required
Requirements
What you’ll need- High school graduate or equivalent
- Associate’s degree preferred
- Three to five (3-5) years of physician billing/coding experience, preferably in a computerized physician billing department or large physician group practice
- Epic experience preferred
- An equivalent combination of experience and education may be substituted
- Prior experience with and understanding CARC/RARC codes
- Thorough understanding of the revenue cycle process, from patient access through Patient Financial Services procedures and policies
- Knowledge of medical terminology
- Knowledge of physician billing and reimbursement policies and procedures
- Knowledge of CPT4 and ICD10 codes as they relate to physician billing
- Knowledge of physician office practices
- Ability to enter, update, and retrieve information using a personal computer
- Skill in written and oral communication
- Ability to act independently within established guidelines
- Ability to exercise judgment and tact
- Ability to perform intermittent sitting, standing, and walking
- Ability to lift and move light items
- Manual dexterity to initiate calls and provide computer entry
- Sight to dial numbers and read computer screens
Benefits
Comp & perks- Health insurance
- Paid time off
- Retirement
- Employee assistance program
- Competitive suite of employee benefits to maximize the wellness of you and your family